I 
116TH CONGRESS 
1ST SESSION H. R. 3984 
To improve access to emergency medical services, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 25, 2019 
Mr. FLORES (for himself, Mr. MARSHALL, and Mr. BABIN) introduced the 
following bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To improve access to emergency medical services, 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. 
This Act may be cited as the ‘‘Health Care Safety 
Net Enhancement Act of 2019’’. 
SEC. 2. CONSTITUTIONAL AUTHORITY. 
The constitutional authority upon which this Act 
rests is the power of the Congress to provide for the gen-
eral welfare, to regulate commerce, and to make all laws 
which shall be necessary and proper for carrying into exe-
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cution Federal powers, as enumerated in section 8 of arti-
cle I of the Constitution of the United States. 
SEC. 3. PROTECTION FOR EMERGENCY AND RELATED 
SERVICES 
FURNISHED 
PURSUANT 
TO 
EMTALA. 
Section 224(g) of the Public Health Service Act (42 
U.S.C. 233(g)) is amended— 
(1) in paragraph (4), by striking ‘‘An entity’’ 
and inserting ‘‘Subject to paragraph (6), an entity’’; 
and 
(2) by adding at the end the following: 
‘‘(6)(A) For purposes of this section— 
‘‘(i) an entity described in subparagraph (B) 
shall be considered to be an entity described in para-
graph (4); and 
‘‘(ii) the provisions of this section shall apply to 
an entity described in subparagraph (B) in the same 
manner as such provisions apply to an entity de-
scribed in paragraph (4), except that— 
‘‘(I) notwithstanding paragraph (1)(B), the 
deeming of any entity described in subpara-
graph (B), or of an officer, governing board 
member, employee, contractor, or on-call pro-
vider of such an entity, to be an employee of 
the Public Health Service for purposes of this 
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section shall apply only with respect to items 
and services that are furnished to an individual 
pursuant to section 1867 of the Social Security 
Act and to post stabilization services (as de-
fined in subparagraph (D)) furnished to such 
an individual; 
‘‘(II) nothing in paragraph (1)(D) shall be 
construed as preventing a physician or physi-
cian group described in subparagraph (B)(ii) 
from making the application referred to in such 
paragraph or as conditioning the deeming of a 
physician or physician group that makes such 
an application upon receipt by the Secretary of 
an application from the hospital or emergency 
department that employs or contracts with the 
physician or group, or enlists the physician or 
physician group as an on-call provider; 
‘‘(III) notwithstanding paragraph (3), this 
paragraph shall apply only with respect to 
causes of action arising from acts or omissions 
that occur on or after the date that is 6 months 
after the date of enactment of this paragraph; 
‘‘(IV) paragraph (5) shall not apply to a 
physician or physician group described in sub-
paragraph (B)(ii); 
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‘‘(V) the Attorney General, in consultation 
with the Secretary, shall make separate esti-
mates under subsection (k)(1) with respect to 
entities described in subparagraph (B) and enti-
ties described in paragraph (4) (other than 
those described in subparagraph (B)), and the 
Secretary shall establish separate funds under 
subsection (k)(2) with respect to such groups of 
entities, and any appropriations under this sub-
section for entities described in subparagraph 
(B) shall be separate from the amounts author-
ized by subsection (k)(2); 
‘‘(VI) notwithstanding subsection (k)(2), 
the amount of the fund established by the Sec-
retary under such subsection with respect to en-
tities described in subparagraph (B) may ex-
ceed a total of $10,000,000 for a fiscal year; 
and 
‘‘(VII) subsection (m) shall not apply to 
entities described in subparagraph (B). 
‘‘(B) An entity described in this subparagraph is— 
‘‘(i) a hospital or an emergency department to 
which section 1867 of the Social Security Act ap-
plies; and 
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‘‘(ii) a physician or physician group that is em-
ployed by, is under contract with, or is an on-call 
provider of such hospital or emergency department, 
to furnish items and services to individuals under 
such section. 
‘‘(C) For purposes of this paragraph, the term ‘on- 
call provider’ means a physician or physician group that— 
‘‘(i) has full, temporary, or locum tenens staff 
privileges at a hospital or emergency department to 
which section 1867 of the Social Security Act ap-
plies; and 
‘‘(ii) is not employed by or under contract with 
such hospital or emergency department, but agrees 
to be ready and available to provide services pursu-
ant to section 1867 of the Social Security Act or 
post stabilization services to individuals being treat-
ed in the hospital or emergency department with or 
without compensation from the hospital or emer-
gency department. 
‘‘(D) For purposes of this paragraph, the term ‘post 
stabilization services’ means, with respect to an individual 
who has been treated by an entity described in subpara-
graph (B) for purposes of complying with section 1867 
of the Social Security Act, services that are— 
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