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SECTION 1. SHORT TITLE.

This Act may be cited as the ''Ensuring Access to Emergency Rooms
Act of 2004''.

SEC. 2. CONSTITUTIONAL AUTHORITY.

The constitutional authority upon which this Act rests is the power
of the Congress to provide for the general welfare, to regulate
commerce, and to make all laws which shall be necessary and proper for
carrying into execution Federal powers, as enumerated in section 8 of
article I of the Constitution of the United States.

SEC. 3. PROTECTION AGAINST LEGAL LIABILITY FOR EMERGENCY AND RELATED
SERVICES FURNISHED TO UNINSURED INDIVIDUALS.

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 in lieu thereof ''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 paragraph
(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 described
in paragraph (4), except that--
''(I) notwithstanding paragraph (1)(B), the
deeming of any entity described in subparagraph
(B), or of an officer, governing board member,
employee, or contractor of such an entity, to
be an employee of the Public Health Service for
purposes of this section shall apply only with
respect to items and services that are
furnished to an uninsured individual (as
defined in subparagraph (C)) pursuant to
section 1867 of the Social Security Act and to
post-stabilization services (as defined in
subparagraph (D)) furnished to such an
individual;
''(II) nothing in paragraph (1)(D) shall be
construed as preventing a physician or
physician 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;
''(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 January 1, 2003;
''(IV) paragraph (5) shall not apply to a
physician or physician group described in
subparagraph (B)(ii);
''(V) the Attorney General, in consultation
with the Secretary, shall make separate
estimates under subsection (k)(1) with respect
to entities described in subparagraph (B) and
entities 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
subsection for entities described in
subparagraph (B) shall be separate from the
amounts authorized by subsection (k)(2);
''(VI) notwithstanding subsection (k)(2),
the amount of the fund established by the
Secretary under such subsection with respect to
entities described in subparagraph (B) may
exceed 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 applies;
and
''(ii) a physician or physician group that is
employed by, or under contract with, such hospital or
department to furnish items and services to individuals
under such section.
''(C) For purposes of this paragraph, the term 'uninsured
individual' means an individual who, at the time treatment is
provided by an entity described in subparagraph (B) for
purposes of complying with section 1867 of the Social Security
Act--
''(i) does not have coverage under--
''(I) a group health plan (as defined in
section 2791(a)(1));
''(II) part A or B of title XVIII of the
Social Security Act; or
''(III) a State plan under title XIX of
such Act; and
''(ii) does not have health insurance coverage (as
defined in section 2791(b)(1) of the Public Health
Service Act (42 U.S.C. 300gg-91(b)(1)) from any other
source.
''(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 subparagraph (B)
for purposes of complying with section 1867 of the Social
Security Act, services that are--
''(i) related to the condition that was so treated;
and
''(ii) provided after the individual is stabilized
in order to maintain the stabilized condition or to
improve or resolve the individual's condition.
''(E)(i) Nothing in this paragraph (or in any other
provision of this section as such provision applies to entities
described in subparagraph (B) by operation of subparagraph (A))
shall be construed as authorizing or requiring the Secretary to
make payments to such entities, the budget authority for which
is not provided in advance by appropriation Acts.
''(ii) The Secretary shall limit the total amount of
payments under this paragraph for a fiscal year to the total
amount appropriated in advance by appropriation Acts for such
purpose for such fiscal year. If the total amount of payments
that would otherwise be made under this paragraph for a fiscal
year exceeds such total amount appropriated, the Secretary
shall take such steps as may be necessary to ensure that the
total amount of payments under this paragraph for such fiscal
year does not exceed such total amount appropriated.''.
Ensuring Access to Emergency Rooms Act of 2004 - Amends the Public Health Service Act to deem hospitals, emergency rooms, physicians, and physicians groups that provide emergency care to uninsured individuals employees of the Public Health Service for purposes of any civil action that may arise due to items and services furnished and post-stabilization services provided to such individuals.

Requires the Attorney General to make separate estimates as to the cost of claims expected to arise under this Act and to establish separate funds for such claims. Requires the Secretary of Health and Human Services to limit the total amount of payments under this Act to the amounts appropriated in advance for such purposes.