I 
110TH CONGRESS 
1ST SESSION 
H. R. 882 
To amend title XVIII of the Social Security Act to improve access to emer-
gency medical services and the quality of care furnished in emergency 
departments of hospitals and critical access hospitals by establishing 
a bipartisan commission to examine factors that affect the effective 
delivery of such services, by providing for additional payments for certain 
physician services furnished in such emergency departments, and by 
requiring reports on certain emergency department information as a 
condition of participation in the Medicare program, and for other pur-
poses. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 7, 2007 
Mr. GORDON of Tennessee (for himself, Mr. SESSIONS, Mr. ALLEN, Ms. JACK-
SON-LEE of Texas, Mr. HAYES, Mr. ENGLISH of Pennsylvania, Mr. 
MCNULTY, Mr. COHEN, Mrs. MCCARTHY of New York, Mrs. CAPPS, Mr. 
CHANDLER, Mr. SENSENBRENNER, Mr. LARSEN of Washington, Mr. 
HOLT, Mr. PRICE of Georgia, Mr. MCCAUL of Texas, Mr. DENT, Mr. 
SOUDER, and Ms. ROYBAL-ALLARD) introduced the following bill; which 
was referred to the Committee on Energy and Commerce, and in addition 
to the Committee on Ways and Means, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to improve 
access to emergency medical services and the quality 
of care furnished in emergency departments of hospitals 
and critical access hospitals by establishing a bipartisan 
commission to examine factors that affect the effective 
delivery of such services, by providing for additional pay-
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ments for certain physician services furnished in such 
emergency departments, and by requiring reports on cer-
tain emergency department information as a condition 
of participation in the Medicare program, and for other 
purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) IN GENERAL.—This Act may be cited as the ‘‘Ac-
cess to Emergency Medical Services Act of 2007’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—BIPARTISAN COMMISSION ON ACCESS TO EMERGENCY 
MEDICAL SERVICES 
Sec. 101. Establishment. 
Sec. 102. Duties. 
Sec. 103. Membership. 
Sec. 104. Staff and consultants. 
Sec. 105. Powers. 
Sec. 106. Report on ways to promote the effective delivery of emergency med-
ical services. 
Sec. 107. Termination. 
Sec. 108. Authorization of appropriations. 
TITLE II—ADDITIONAL PAYMENTS FOR CERTAIN PHYSICIANS’ 
SERVICES 
Sec. 201. Additional payments for certain physicians’ services. 
TITLE III—HOSPITAL AND CRITICAL ACCESS REPORTING ON 
CERTAIN EMERGENCY DEPARTMENT INFORMATION 
Sec. 301. Requirement to report information on certain emergency department 
information as condition of Medicare participation. 
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TITLE I—BIPARTISAN COMMIS-
SION ON ACCESS TO EMER-
GENCY MEDICAL SERVICES 
SEC. 101. ESTABLISHMENT. 
There is established the United States Bipartisan 
Commission on Access to Emergency Medical Services (in 
this title referred to as the ‘‘Commission’’). 
SEC. 102. DUTIES. 
(a) IN GENERAL.—The Commission shall perform 
the following duties: 
(1) Identify and examine factors (including fac-
tors described in subsection (b)) in the health care 
delivery, financing, and legal systems that affect the 
effective delivery of screening and stabilization serv-
ices furnished in hospitals that have emergency de-
partments pursuant to EMTALA. 
(2) Make specific recommendations to Con-
gress, taking into account the considerations speci-
fied in subsection (c), with respect to Federal pro-
grams, policies, and financing needed to assure the 
availability of such screening and stabilization serv-
ices and the coordination of State, local, and Federal 
programs for responding to disasters and emer-
gencies. 
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(b) FACTORS CONSIDERED.—For purposes of sub-
section (a)(1), the Commission shall examine at least the 
following factors, with respect to emergency departments 
of hospitals: 
(1) Crowded conditions in such emergency de-
partments and the practice of boarding patients who 
require admission, or have already been admitted, to 
a hospital for extended periods in such departments 
and in the areas adjacent to such departments. 
(2) With respect to individuals who present at 
such emergency departments for the treatment of 
emergency medical conditions, any barriers that im-
pede access within a reasonable period of time to 
screening, stabilization services, and other appro-
priate consultations of physicians listed by the hos-
pital on its list of on-call physicians. 
(3) The potential legal and financial liability of 
health care professionals and providers with respect 
to services required to be furnished to patients 
under EMTALA, relating to the requirement of 
emergency departments to screen and appropriately 
treat or transfer individuals presenting themselves at 
the departments with emergency medical conditions 
and women in labor. 
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(c) CONSIDERATIONS
IN RECOMMENDATIONS.—In 
making recommendations under subsection (a)(2), the 
Commission shall consider the following: 
(1) Any changes in Federal law that would be 
necessary to promote the effective delivery of emer-
gency medical services. 
(2) The amount and sources of Federal funds 
to finance such changes. 
(3) The advantages and disadvantages of alter-
native approaches to protecting health care profes-
sionals and providers from legal and financial liabil-
ity with respect to services required to be furnished 
to individuals under EMTALA, such as establishing 
Federal limits on such liability— 
(A) that would supersede any conflicting 
State law related to such liability; and 
(B) which may be the same as appropriate 
limits on liability that are established for public 
health professionals. 
(4) The most efficient and effective manner of 
coordinating State, local, and Federal programs for 
responding to disasters and emergencies, with re-
spect to the delivery of emergency medical services. 
(d) DEFINITIONS.—For purposes of this title: 
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(1) HOSPITAL.—The term ‘‘hospital’’ has the 
meaning given such term in section 1867(e)(5) of 
the Social Security Act (42 U.S.C. 1395dd)). 
(2) EMTALA.—The term ‘‘EMTALA’’ means 
section 1867 of the Social Security Act (42 U.S.C. 
1395dd). 
SEC. 103. MEMBERSHIP. 
(a) APPOINTMENT.— 
(1) The Commission shall be composed of 18 
members, who shall be appointed not later than the 
date that is 60 days after the date of the enactment 
of this Act and in accordance with paragraph (2), as 
follows: 
(A) The President shall appoint six mem-
bers of the Commission. 
(B) The Speaker of the House of Rep-
resentatives, after consultation with the minor-
ity leader of the House of Representatives, shall 
appoint six members of the Commission. 
(C) The majority leader of the Senate, 
after consultation with the minority leader of 
the Senate, shall appoint six members of the 
Commission. 
(2) Of the members appointed under paragraph 
(1), the President, the Speaker of the House of Rep-
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resentatives, and the majority leader of the Senate 
shall each appoint as members of the commission— 
(A) two individuals who represent physi-
cians and other health care professionals who 
provide emergency medical services; 
(B) two individuals who are elected or ap-
pointed Federal, State, or local officials and 
who are involved in issues and programs related 
to the provision of emergency medical services; 
and 
(C) two health care consumer advocates. 
(b) CHAIRMAN AND VICE CHAIRMEN.—The Commis-
sion shall elect a chairman and four vice chairmen from 
among its members. 
(c) TERMS.—Each member shall be appointed for the 
life of the Commission. 
(d) VACANCIES.—Any member appointed to fill a va-
cancy occurring before the expiration of the term for which 
the member’s predecessor was appointed shall be ap-
pointed only for the remainder of that term. A member 
may serve after the expiration of that member’s term until 
a successor has taken office. Any vacancy in the member-
ship of the Commission shall be filled in the manner in 
which the original appointment was made and shall not 
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affect the power of the remaining members to execute the 
duties of the Commission. 
(e) COMPENSATION.— 
(1) IN GENERAL.—Members of the Commission 
shall serve without pay. 
(2) TRAVEL EXPENSES.—All members of the 
Commission shall be reimbursed for travel and per 
diem in lieu of subsistence expenses during the per-
formance of duties of the Commission while away 
from their homes or regular places of business, in 
accordance with subchapter I of chapter 57 of title 
5, United States Code. 
(f) QUORUM.—A quorum shall consist of nine mem-
bers of the Commission, except that six or more members 
may conduct a hearing under section 105(a). 
(g) MEETINGS.—The Commission shall meet at the 
call of its chairman or a majority of its members. 
SEC. 104. STAFF AND CONSULTANTS. 
(a) STAFF.—The Commission may appoint and de-
termine the compensation of such staff as may be nec-
essary to carry out the duties of the Commission. Such 
appointments and compensation may be made without re-
gard to the provisions of title 5, United States Code, that 
govern appointments in the competitive services, and the 
provisions of chapter 51 and subchapter III of chapter 53 
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of such title that relate to classifications and the General 
Schedule pay rates. 
(b) CONSULTANTS.—The Commission may procure 
such temporary and intermittent services of experts and 
consultants as the Commission determines to be necessary 
to carry out the duties of the Commission, in accordance 
with section 3109(b) of title 5, United States Code, but 
at rates for individuals not to exceed the daily equivalent 
of the maximum annual rate of basic pay payable for 
grade GS–15 of the General Schedule under section 5332 
of such title. 
(c) DETAIL OF FEDERAL EMPLOYEES.—Upon the 
request of the Commission, the head of any Federal agen-
cy is authorized to detail, without reimbursement to the 
agency, any of the personnel of such agency to the Com-
mission to assist the Commission in carrying out its du-
ties. Any such detail shall not interrupt or otherwise affect 
the civil service status or privileges of such personnel. 
SEC. 105. POWERS. 
(a) HEARINGS AND OTHER ACTIVITIES.—The Com-
mission may, for the purpose of carrying out this Act, hold 
hearings, sit and act at times and places, take testimony, 
and receive evidence as the Commission determines nec-
essary to carry out its duties. The Commission may ad-
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minister oaths or affirmations to witnesses appearing be-
fore it. 
(b) STUDIES BY GOVERNMENT ACCOUNTABILITY OF-
FICE.—Upon the request of the Commission, the Comp-
troller General shall conduct such studies or investigations 
as the Commission determines to be necessary to carry 
out its duties. 
(c) COST ESTIMATES BY CONGRESSIONAL BUDGET 
OFFICE.— 
(1) DUTY
TO
PROVIDE
REQUESTED
ESTI-
MATES.—Upon the request of the Commission, the 
Director of the Congressional Budget Office shall 
provide to the Commission such cost estimates as 
the Commission determines to be necessary to carry 
out its duties. 
(2) REIMBURSEMENT
FOR
DEVELOPMENT
OF 
COST ESTIMATES.—The Commission shall reimburse 
the Director of the Congressional Budget Office for 
expenses relating to the employment in the office of 
the Director of such additional staff as may be nec-
essary for the Director to comply with requests by 
the Commission under paragraph (1). 
(d) TECHNICAL ASSISTANCE.—Upon the request of 
the Commission, the head of a Federal agency shall pro-
vide such technical assistance to the Commission as the 
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Commission determines to be necessary to carry out its 
duties. 
(e) USE OF MAILS.—The Commission may use the 
United States mails in the same manner and under the 
same conditions as Federal agencies, and shall, for pur-
poses of the frank, be considered a commission of Con-
gress as described in section 3215 of title 39, United 
States Code. 
(f) OBTAINING
INFORMATION.—The Commission 
may secure directly from any Federal agency information 
necessary to enable it to carry out its duties, if the infor-
mation may be disclosed under section 552 of title 5, 
United States Code. Upon request of the Chairman of the 
Commission, the head of such agency shall furnish such 
information to the Commission. 
(g) ADMINISTRATIVE SUPPORT SERVICES.—Upon 
the request of the Commission, the Administrator of Gen-
eral Services shall provide to the Commission on a reim-
bursable basis such administrative support services as the 
Commission may request. 
(h) ACCEPTANCE OF DONATIONS.—The Commission 
may accept, use, and dispose of gifts and donations of 
services or property. 
(i) PRINTING.—For purposes of costs relating to 
printing and binding, including the costs of personnel de-
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