This bill would change parts of the Social Security Act so certain services given at freestanding emergency centers (FECs) are covered by Medicare Part B and Medicaid. It adds a new definition for a freestanding emergency center, lists staffing and location rules, applies EMTALA requirements to these centers, and sets how Medicare would pay for the covered services. The bill also says some lab and imaging services tied to those emergency visits are not barred by the physician self-referral prohibition. The changes apply to items and services furnished on or after the date the bill becomes law.
If you use Medicare or Medicaid, you could get covered emergency care at a freestanding emergency center that meets the bill's rules. These centers must be open 24/7 with a physician available, have arrangements with hospitals for patient transfers, and follow state emergency rules. The bill treats these centers like hospital emergency departments for certain rules and payment purposes.
The bill text includes a finding that an actuarial study of Medicare claims data "found that FECs did not increase overall utilization of emergency care services and saved the Medicare program 21.8 percent in lower emergency care payments for patients of similar acuity." The bill itself does not include an official Congressional Budget Office or other federal cost estimate. No publicly available information on a formal federal cost or savings estimate is included in the bill text.
The bill's findings say FECs expanded provider capacity during the COVID-19 emergency, are staffed and licensed like hospital emergency departments, follow EMTALA and state rules, and have provided high-quality emergency services. The sponsors point to the cited actuarial study and argue FECs can save Medicare money while increasing access to emergency care.
No publicly available information.