EMTALA IMPROVEMENTS.

SEC. 944. EMTALA IMPROVEMENTS.(a) Payment for EMTALA-Mandated Screening and Stabilization Services.—(1) In general.—Section 1862 (42 U.S.C. 1395y) is amended by inserting after subsection (c) the following new subsection:“(d) For purposes of subsection (a)(1)(A), in the case of any item or service that is required to be provided pursuant to section 1867 to an individual who is entitled to benefits under this title, determinations as to whether the item or service is reasonable and necessary shall be made on the basis of the information available to the treating physician or practitioner (including the patient’s 117 STAT. 2423 presenting symptoms or complaint) at the time the item or service was ordered or furnished by the physician or practitioner (and not on the patient’s principal diagnosis). When making such determinations with respect to such an item or service, the Secretary shall not consider the frequency with which the item or service was provided to the patient before or after the time of the admission or visit.”.(2) Effective date.—The amendment made by paragraph (1) shall apply to items and services furnished on or after January 1, 2004.(b) Notification of Providers When EMTALA Investigation Closed.—Section 1867(d) (42 U.S.C. 42 U.S.C. 1395dd(d)) is amended by adding at the end the following new paragraph: “(4) Notice upon closing an investigation.—The Secretary shall establish a procedure to notify hospitals and physicians when an investigation under this section is closed.”.(c) Prior Review by Peer Review Organizations in EMTALA Cases Involving Termination of Participation.—(1) In general.—Section 1867(d)(3) (42 U.S.C. 1395dd(d)(3)) is amended—(A) in the first sentence, by inserting “or in terminating a hospital’s participation under this title” after “in imposing sanctions under paragraph (1)”; and(B) by adding at the end the following new sentences: “Except in the case in which a delay would jeopardize the health or safety of individuals, the Secretary shall also request such a review before making a compliance determination as part of the process of terminating a hospital’s participation under this title for violations related to the appropriateness of a medical screening examination, stabilizing treatment, or an appropriate transfer as required by this section, and shall provide a period of 5 days for such review. The Secretary shall provide a copy of the organization’s report to the hospital or physician consistent with confidentiality requirements imposed on the organization under such part B.”.(2) Effective date.—The amendments made by paragraph (1) shall apply to terminations of participation initiated on or after the date of the enactment of this Act.