TITLE II—ADDITIONAL 
MEDICARE PAYMENT 
SEC. 201. ADDITIONAL PAYMENTS FOR PHYSICIANS’ SERV-
ICES FURNISHED IN AN EMERGENCY DE-
PARTMENT OF A HOSPITAL OR CRITICAL AC-
CESS HOSPITAL. 
Section 1833 of the Social Security Act (42 U.S.C. 
1395l) is amended by adding at the end the following new 
subsection: 
‘‘(v) ADDITIONAL
PAYMENTS
FOR
PHYSICIANS’ 
SERVICES FURNISHED IN EMERGENCY DEPARTMENTS.— 
In the case of physicians’ services furnished on or after 
January 1, 2006, in the emergency department of a hos-
pital or critical access hospital to an individual covered 
under the insurance program established by this part, in 
addition to the amount of payment that will otherwise be 
made for such services under this part, there shall also 
be paid to the physician or other person (or to an employer 
or other entity in the cases described in clause (A) of sec-
tion 1842(b)(6)) from the Federal Supplementary Insur-
ance Trust Fund an amount equal to 10 percent of the 
payment amount for the service under this part.’’.
SEC. 202. INCENTIVE PAYMENTS FOR HOSPITALS MEETING 
STANDARDS FOR PROMPT ADMISSIONS OF 
EMERGENCY DEPARTMENT PATIENTS RE-
QUIRING INPATIENT HOSPITAL SERVICES. 
(a) IN GENERAL.— 
(1) INCENTIVE PAYMENTS.—Section 1833(t) of 
the Social Security Act (42 U.S.C. 1395l(t)) is 
amended by adding at the end the following: 
‘‘(15) INCENTIVE PAYMENTS FOR PROMPT AD-
MISSIONS
OF
CERTAIN
EMERGENCY
DEPARTMENT 
PATIENTS.— 
‘‘(A) IN GENERAL.— 
‘‘(i) ADDITIONAL PAYMENT.—Subject 
to subparagraph (C)(i), in the case of 
emergency department visits furnished in a 
calendar quarter beginning on or after 
January 1, 2007, by a hospital that has 
transmitted a certification pursuant to 
clause (ii) for such quarter there shall be 
paid to the hospital for such visits an 
amount equal to— 
‘‘(I) 10 percent of the amount 
otherwise payable under this sub-
section for such visits (which shall be 
in addition to such payment amount); 
or
‘‘(II) in the case of visits for 
which payment may not be made 
under this subsection by reason of the 
bundling 
requirements 
of 
section 
1886(a)(4), 10 percent of the amount 
that would have been paid for such 
visits but for the admission of the pa-
tient involved for inpatient hospital 
services. 
‘‘(ii) CERTIFICATION
PROCESS.—In 
order to qualify for additional payments 
under this paragraph for a quarter, a hos-
pital shall transmit to the Secretary (at 
such time before the beginning of such 
quarter as the Secretary may require) a 
certification that, for second preceding 
quarter, the hospital met the standards es-
tablished under subparagraph (B). 
‘‘(iii) EMERGENCY DEPARTMENT VIS-
ITS.—For purposes of this paragraph, the 
term ‘emergency department visits’ means 
ambulatory patient classification groups 
0600, 0601, 0602, 0610, 0611, 0612, and 
0620 (and any successor groups as deter-
mined by the Secretary).
‘‘(B) STANDARDS
FOR
PROMPT
ADMIS-
SIONS.— 
‘‘(i) TIMING.—Not later than June 
30, 2006, the Secretary shall promulgate 
final regulations (after notice and an op-
portunity for public comment) establishing 
standards for prompt admission by a hos-
pital of those individuals presenting to the 
emergency department of the hospital who 
are determined at the time an emergency 
department visit to require inpatient hos-
pital services at the hospital (hereafter in 
this paragraph referred to as ‘emergency 
department patients requiring admission’ 
or ‘such patients’). 
‘‘(ii) REQUIREMENTS.—The standards 
under clause (i) shall— 
‘‘(I) be designed to substantially 
reduce or eliminate overcrowding and 
boarding of patients in such depart-
ments and in other outpatient setting 
adjacent to such departments; 
‘‘(II) be expressed as an average 
of the time elapsed between the deci-
sion to admit such patients and the