I 
111TH CONGRESS 
1ST SESSION H. R. 1188 
To amend title XVIII of the Social Security Act to improve access to emer-
gency medical services and the quality and efficiency 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 establishing a Centers for Medicare & Medicaid Services Working 
Group, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 25, 2009 
Mr. GORDON of Tennessee (for himself, Mr. SESSIONS, Mr. MCGOVERN, Mr. 
THOMPSON of California, Mr. GRAVES, Mr. WILSON of Ohio, Mr. 
LANGEVIN, Mr. HOLT, Mr. RYAN of Ohio, Mr. FRELINGHUYSEN, Mr. 
HINOJOSA, Mr. SCHIFF, Ms. DELAURO, Mr. FARR, Mr. CHANDLER, Mr. 
LOBIONDO, Mr. MCCAUL, Mr. ROGERS of Michigan, Mrs. BLACKBURN, 
Mr. KLEIN of Florida, Mr. DENT, Mr. KUCINICH, Mr. CARSON of Indi-
ana, Mr. KENNEDY, Mr. BOUSTANY, Mr. SIRES, Mr. LARSON of Con-
necticut, Mr. CAPUANO, Mr. SENSENBRENNER, Mr. MARCHANT, Mr. 
GERLACH, Mr. COURTNEY, Mr. SOUDER, Ms. ZOE LOFGREN of Cali-
fornia, Mr. MASSA, Ms. MCCOLLUM, Mr. HARE, Ms. SCHWARTZ, Mr. 
BISHOP of New York, Mr. HINCHEY, Mr. BURGESS, Mrs. BACHMANN, 
Mr. LANCE, Mr. GENE GREEN of Texas, Mr. PRICE of North Carolina, 
Mr. PASCRELL, Mr. CASTLE, Mr. KILDEE, Mr. WILSON of South Caro-
lina, Mr. WU, Mr. SMITH of New Jersey, and Mr. PLATTS) 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 provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To amend title XVIII of the Social Security Act to improve 
VerDate Nov 24 2008 
22:51 Feb 26, 2009
Jkt 079200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6652
E:\BILLS\H1188.IH
H1188
mstockstill on PROD1PC66 with BILLS
access to emergency medical services and the quality 
and efficiency of care furnished in emergency depart-
ments of hospitals and critical access hospitals by estab-
lishing 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 estab-
lishing a Centers for Medicare & Medicaid Services 
Working Group, 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 2009’’. 
(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—CENTERS FOR MEDICARE & MEDICAID SERVICES 
WORKING GROUP TO IMPROVE EMERGENCY CARE EFFICIENCY 
Sec. 301. Centers for Medicare & Medicaid Services Working Group to improve 
emergency care efficiency. 
VerDate Nov 24 2008 
22:51 Feb 26, 2009
Jkt 079200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6211
E:\BILLS\H1188.IH
H1188
mstockstill on PROD1PC66 with BILLS
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. 
VerDate Nov 24 2008 
22:51 Feb 26, 2009
Jkt 079200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H1188.IH
H1188
mstockstill on PROD1PC66 with BILLS