I 
111TH CONGRESS 
1ST SESSION H. R. 1678 
To amend the Internal Revenue Code of 1986 to allow a bad debt deduction 
to doctors to partially offset the cost of providing uncompensated care 
required to be provided under amendments made by the Emergency 
Medical Treatment and Labor Act. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 24, 2009 
Mrs. BONO MACK introduced the following bill; which was referred to the 
Committee on Ways and Means 
A BILL 
To amend the Internal Revenue Code of 1986 to allow a 
bad debt deduction to doctors to partially offset the 
cost of providing uncompensated care required to be 
provided under amendments made by the Emergency 
Medical Treatment and Labor Act. 
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 ‘‘Mitigating the Impact 
of Uncompensated Service and Time Act of 2009’’. 
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SEC. 2. BAD DEBT DEDUCTION FOR DOCTORS TO PAR-
TIALLY OFFSET THE COST OF PROVIDING UN-
COMPENSATED CARE REQUIRED TO BE PRO-
VIDED UNDER AMENDMENTS MADE BY THE 
EMERGENCY 
MEDICAL 
TREATMENT 
AND 
LABOR ACT. 
(a) IN GENERAL.—Section 166 of the Internal Rev-
enue Code of 1986 (relating to bad debts) is amended by 
redesignating subsection (f) as subsection (g) and by in-
serting after subsection (e) the following new subsection: 
‘‘(f) BAD DEBT TREATMENT FOR DOCTORS TO PAR-
TIALLY OFFSET COST OF PROVIDING UNCOMPENSATED 
CARE REQUIRED TO BE PROVIDED.— 
‘‘(1) AMOUNT OF DEDUCTION.— 
‘‘(A) IN GENERAL.—For purposes of sub-
section (a), the basis for determining the 
amount of any deduction for an eligible 
EMTALA debt shall be treated as being equal 
to the excess of— 
‘‘(i) the Medicare payment amount, 
over 
‘‘(ii) any other compensation received 
with respect to such debt. 
‘‘(B) MEDICARE PAYMENT AMOUNT.—For 
purposes of subparagraph (A), the Medicare 
payment amount with respect to an eligible 
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EMTALA debt is the fee schedule amount es-
tablished under section 1848 of the Social Secu-
rity Act for the physicians’ service (to which 
such debt relates) as if the service were pro-
vided to an individual enrolled under part B of 
title XVIII of such Act. 
‘‘(2) ELIGIBLE EMTALA DEBT.—For purposes 
of this section, the term ‘eligible EMTALA debt’ 
means any debt if— 
‘‘(A) such debt arose as a result of physi-
cians’ services— 
‘‘(i) which were performed in an 
EMTALA hospital by a physician (whether 
as part of medical screening or necessary 
stabilizing treatment and whether as an 
emergency department physician, as an on- 
call physician, or otherwise), and 
‘‘(ii) which were required to be pro-
vided under section 1867 of the Social Se-
curity Act (42 U.S.C. 1395dd), and 
‘‘(B) such debt is owed— 
‘‘(i) to such physician, or 
‘‘(ii) to an entity if— 
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‘‘(I) such entity is a corporation 
and the sole shareholder of such cor-
poration is such physician, or 
‘‘(II) such entity is a partnership 
and any deduction under this sub-
section with respect to such debt is al-
located to such physician or to an en-
tity described in subclause (I). 
‘‘(3) OTHER
DEFINITIONS.—For purposes of 
this subsection— 
‘‘(A) EMERGENCY
DEPARTMENT
PHYSI-
CIAN.—The term ‘emergency department physi-
cian’ means any physician who is recognized as 
a career emergency physician, as evidenced by 
membership in the American College of Emer-
gency Physicians, or is certified by the Amer-
ican Board of Emergency Medicine, the Amer-
ican Osteopathic Board of Emergency Medicine, 
or the American Board of Pediatrics. 
‘‘(B) PHYSICIAN.—The term ‘physician’ 
has the meaning given such term in section 
1861(r) of the Social Security Act (42 U.S.C. 
1395x(r)). 
‘‘(C) EMTALA 
HOSPITAL.—The term 
‘EMTALA hospital’ means any hospital having 
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a hospital emergency department which is re-
quired to comply with section 1867 of the So-
cial Security Act (42 U.S.C. 1395dd) (relating 
to examination and treatment for emergency 
medical conditions and women in labor). 
‘‘(D) PHYSICIANS’ SERVICES.—The term 
‘physicians’ services’ has the meaning given 
such term in section 1861(q) of the Social Se-
curity Act (42 U.S.C. 1395x(q)).’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to debts arising from services per-
formed in taxable years beginning after the date of the 
enactment of this Act. 
Æ 
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