Emergency Care Improvement Act
Sponsored By: Representative Arrington
Introduced
Summary
Recognize freestanding emergency centers as Medicare and Medicaid providers. The bill would let these centers bill Medicare Part B and be covered by Medicaid for most emergency services while setting federal standards for staffing, governance, quality, payments, and EMTALA responsibilities.
Show full summary
- Families and patients: Adds “specified emergency services” furnished by freestanding emergency centers to Medicare Part B and to the list of Medicaid-covered services. It excludes the lowest-acuity evaluation and management codes 99281–99282.
- Providers and operators: Establishes a statutory definition and requires 24/7 physician staffing, hospital referral or admission arrangements, a governing body, and a continuous quality assessment program. Location rules limit qualifying facilities based on metropolitan or specific rural county criteria.
- Payers and legal rules: Medicare payments for these services would be set like outpatient department payments and Medicaid would cover the same specified emergency services. The bill treats freestanding emergency centers as hospitals for EMTALA and extends physician self-referral prohibitions to FEC lab and imaging services, with the changes applying to items and services furnished on or after enactment.
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 2 benefits, 0 costs, 2 mixed.
Medicare and Medicaid cover freestanding emergency centers
If enacted, Medicare Part B and Medicaid would cover specified emergency care at qualifying freestanding emergency centers. Centers would need a doctor on site 24/7, hospital referral agreements, a governing body, and a quality program. Location limits would apply: metro areas, or certain rural counties; newer rural sites would qualify only if the county has no Medicare hospital or rural emergency hospital. Very low‑level visits (HCPCS 99281–99282) would be excluded from this coverage. Coverage would start for care given on or after the date of enactment.
Emergency care protections at freestanding centers
If enacted, freestanding emergency centers would be treated like hospitals under federal emergency care rules. People who arrive at these centers would get the same screening and stabilization protections. This would apply to care on or after enactment.
Medicare pays freestanding emergency centers like hospitals
If enacted, Medicare would pay for qualifying freestanding emergency center care using hospital outpatient payment rules. This could change what centers are paid and could change your copay for those visits. The bill does not set dollar amounts. The rule would apply to services on or after enactment.
Narrow self-referral exception at freestanding emergency centers
If enacted, some lab and imaging done at freestanding emergency centers during an emergency visit would fit a narrow doctor self‑referral exception. This could make it easier for centers to offer on‑site tests, but effects on patient costs are unclear. It would apply to services on or after enactment.
Sponsors & CoSponsors
Sponsor
Arrington
TX • R
Cosponsors
Gonzalez, V.
TX • D
Sponsored 5/1/2025
Crenshaw
TX • R
Sponsored 5/1/2025
Van Duyne
TX • R
Sponsored 5/1/2025
McCaul
TX • R
Sponsored 7/10/2025
McCormick
GA • R
Sponsored 7/29/2025
Tenney
NY • R
Sponsored 8/1/2025
Babin
TX • R
Sponsored 8/12/2025
Kelly (PA)
PA • R
Sponsored 8/12/2025
Weber (TX)
TX • R
Sponsored 8/12/2025
Jackson (TX)
TX • R
Sponsored 9/23/2025
Cloud
TX • R
Sponsored 9/26/2025
Pfluger
TX • R
Sponsored 10/6/2025
Ruiz
CA • D
Sponsored 2/13/2026
Roll Call Votes
No roll call votes available for this bill.
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