H.R. 3134 — Emergency Care Improvement Act

This section states congressional findings concerning freestanding emergency centers (FECs), including (1) the Centers for Medicare & Medicaid Services' April 2020 waiver allowing FECs to enroll as Medicare-certified hospitals during the COVID-19 public health emergency; (2) FECs' status as fully licensed, 24/7-staffed emergency departments with pharmacies, laboratories, and imaging that meet the same standards as hospital-based emergency rooms, including EMTALA requirements; (3) enrollment of over 118 FECs, mostly in Texas, which provided emergency services at savings to Medicare and beneficiaries; and (4) an actuarial study finding no increase in emergency care utilization and 21.8% Medicare savings on payments for patients of similar acuity.

This section establishes Medicare Part B and Medicaid coverage for specified emergency services (i.e., certain emergency services excluding low-acuity evaluation and management codes 99281-99282) furnished by freestanding emergency centers (FECs, defined as independent facilities meeting specified staffing, quality, location, and state licensure requirements, including 24/7 physician availability and hospital transfer arrangements); applies the Emergency Medical Treatment and Labor Act (EMTALA, which requires medical screening and stabilization of individuals with emergency medical conditions regardless of insurance or ability to pay) to FECs; sets Medicare payment for such services at the outpatient prospective payment system rate (i.e., as if furnished as covered hospital outpatient department services); and excepts laboratory and imaging services furnished by FECs in connection with specified emergency services from the physician self-referral prohibition (Stark Law). The amendments apply to items and services furnished on or after the date of enactment.