I
106TH CONGRESS
1ST SESSION
H. R. 567
To assure that the services of a nonemergency department physician are
available to hospital patients 24-hours-a-day, seven days a week in all
non-Federal hospitals with at least 100 licensed beds.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY 3, 1999
Mr. VISCLOSKY introduced the following bill; which was referred to the
Committee on Commerce
A BILL
To assure that the services of a nonemergency department
physician are available to hospital patients 24-hours-a-
day, seven days a week in all non-Federal hospitals with
at least 100 licensed beds.
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 ‘‘Physician Availability
Act of 1999’’.
SEC. 2. REQUIREMENT FOR PHYSICIAN AVAILABILITY IN
ACUTE CARE HOSPITALS.
(a) IN GENERAL.—Each covered hospital shall have
a qualified physician available in the hospital 24 hours a
day, seven days a week to attend to the needs of inpatients
of the hospital.
(b) DEFINITIONS.—For purposes of this section:
(1) COVERED HOSPITAL.—
(A) IN
GENERAL.—Subject to subpara-
graph (B), the term ‘‘covered hospital’’ means
a subsection (d) hospital (as defined in section
1886(d)(1)(B) of the Social Security Act (42
U.S.C. 1395ww(d)(1)(B)) that—
(i) has a participation agreement in
effect under section 1866 of such Act (42
U.S.C. 1395cc),
(ii) is participating in the program
under title XIX of such Act, or
(iii) is receiving Federal funds under
a grant or cooperative agreement.
(B) EXCLUSION FOR FEDERAL FACILITIES
AND SMALL HOSPITALS.—Such term does not
include a hospital that—
(i) is a facility of the Federal Govern-
ment, or
(ii) the Secretary of Health and
Human Services determines has fewer than
100 licensed beds (as defined by the Sec-
retary).
(2) PHYSICIAN; QUALIFIED
PHYSICIAN.—(A)
The term ‘‘physician’’ means, with respect to a hos-
pital, an individual who is a doctor of medicine or
osteopathy legally authorized under State law to
practice medicine and surgery in that hospital.
(B) The term ‘‘qualified physician’’ means, with
respect to a hospital, an individual who is a physi-
cian and whose credentials as such a physician have
been verified by the administration of the hospital
(before providing any services at the hospital)
through appropriate means, including verification
through the National Practitioner Databank.
(3) PHYSICIAN AVAILABILITY.—A physician is
considered to be ‘‘available’’ in a hospital if—
(A) the physician is physically present in
the hospital;
(B) the physician’s primary responsibility
is to be in attendance to serve the needs of the
hospital’s inpatients without delay; and
(C) the physician is not physically present
in, assigned to, serving in, or expected to cover,
the hospital’s emergency room or emergency de-
partment.
(c) ENFORCEMENT.—
(1) WARNING.—If the Secretary of Health and
Human Services (in this section referred to as the
‘‘Secretary’’) determines that a hospital has violated
subsection (a), in the first instance the Secretary
shall provide a written warning regarding such viola-
tion to the hospital and shall notify the Inspector
General of the Department of Health and Human
Services (in this section referred to as the ‘‘HHS In-
spector General’’) of such violation. Subsequently,
the HHS Inspector General shall monitor the com-
pliance of the hospital with the requirement of sub-
section (a).
(2) SECOND
VIOLATION.—After providing a
warning to a hospital under paragraph (1), if the
Secretary determines that the hospital subsequently
and knowingly violates subsection (a)—
(A) the hospital is subject to a civil money
penalty in an amount not to exceed $100,000,
and
(B) the hospital shall submit to the HHS
Inspector General, by not later than 30 days
after the date of such a determination, a reme-
dial plan to prevent future violations of the re-
quirement of such subsection.
The provisions of section 1128A of the Social Secu-
rity Act (42 U.S.C. 1320a–7a), other than sub-
sections (a) and (b) of such section, shall apply to
civil money penalties under subparagraph (A) in the
same manner as they apply to a penalty or proceed-
ing under subsection (a) of such section.
(3) SUBSEQUENT VIOLATIONS.—After imposing
a civil money penalty under paragraph (2) against a
hospital, if the Secretary determines that the hos-
pital subsequently and knowingly violates subsection
(a), the Secretary may issue an order disqualifying
the hospital from participation in the programs
under titles XVIII and XIX of the Social Security
Act and from receipt of Federal funds under any
grant or cooperative agreement for such period as
the Secretary specifies and until the Secretary re-
ceives satisfactory assurances that the hospital will
be in substantial compliance with the requirement of
subsection (a).
(4) FAILURE TO SUBMIT OR COMPLY WITH RE-
MEDIAL PLAN.—If the Secretary determines, after
consultation with the HHS Inspector General, that
a hospital has failed to submit a satisfactory reme-
dial plan required under paragraph (2)(B) or is fail-
ing to substantially carry out such a plan, the Sec-
retary may suspend payment of funds to the hospital
under titles XVIII and XIX of the Social Security
Act and under Federal grants or cooperative agree-
ments until the Secretary receives satisfactory assur-
ances that such failures will not continue.
(d) EFFECTIVE DATE.—This section shall take effect
on the first day of the first month that begins more than
180 days after the date of the enactment of this Act.
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