SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Physician Availability Act of 
1999''.

SEC. 2. REQUIREMENT FOR PHYSICIAN AVAILABILITY IN ACUTE CARE HOSPITALS.

    (a) In General.--Each covered hospital shall have a qualified 
physician available in the hospital 24 hours a day, seven days a week 
to attend to the needs of inpatients of the hospital.
    (b) Definitions.--For purposes of this section:
            (1) Covered hospital.--
                    (A) In general.--Subject to subparagraph (B), the 
                term ``covered hospital'' means a subsection (d) 
                hospital (as defined in section 1886(d)(1)(B) of the 
                Social Security Act (42 U.S.C. 1395ww(d)(1)(B)) that--
                            (i) has a participation agreement in effect 
                        under section 1866 of such Act (42 U.S.C. 
                        1395cc),
                            (ii) is participating in the program under 
                        title XIX of such Act, or
                            (iii) is receiving Federal funds under a 
                        grant or cooperative agreement.
                    (B) Exclusion for federal facilities and small 
                hospitals.--Such term does not include a hospital 
                that--
                            (i) is a facility of the Federal 
                        Government, or
                            (ii) the Secretary of Health and Human 
                        Services determines has fewer than 100 licensed 
                        beds (as defined by the Secretary).
            (2) Physician; qualified physician.--(A) The term 
        ``physician'' means, with respect to a hospital, an individual 
        who is a doctor of medicine or osteopathy legally authorized 
        under State law to practice medicine and surgery in that 
        hospital.
            (B) The term ``qualified physician'' means, with respect to 
        a hospital, an individual who is a physician and whose 
        credentials as such a physician have been verified by the 
        administration of the hospital (before providing any services 
        at the hospital) through appropriate means, including 
        verification through the National Practitioner Databank.
            (3) Physician availability.--A physician is considered to 
        be ``available'' in a hospital if--
                    (A) the physician is physically present in the 
                hospital;
                    (B) the physician's primary responsibility is to be 
                in attendance to serve the needs of the hospital's 
                inpatients without delay; and
                    (C) the physician is not physically present in, 
                assigned to, serving in, or expected to cover, the 
                hospital's emergency room or emergency department.
    (c) Enforcement.--
            (1) Warning.--If the Secretary of Health and Human Services 
        (in this section referred to as the ``Secretary'') determines 
        that a hospital has violated subsection (a), in the first 
        instance the Secretary shall provide a written warning 
        regarding such violation to the hospital and shall notify the 
        Inspector General of the Department of Health and Human 
        Services (in this section referred to as the ``HHS Inspector 
        General'') of such violation. Subsequently, the HHS Inspector 
        General shall monitor the compliance of the hospital with the 
        requirement of subsection (a).
            (2) Second violation.--After providing a warning to a 
        hospital under paragraph (1), if the Secretary determines that 
        the hospital subsequently and knowingly violates subsection 
        (a)--
                    (A) the hospital is subject to a civil money 
                penalty in an amount not to exceed $100,000, and
                    (B) the hospital shall submit to the HHS Inspector 
                General, by not later than 30 days after the date of 
                such a determination, a remedial plan to prevent future 
                violations of the requirement of such subsection.
        The provisions of section 1128A of the Social Security Act (42 
        U.S.C. 1320a-7a), other than subsections (a) and (b) of such 
        section, shall apply to civil money penalties under 
        subparagraph (A) in the same manner as they apply to a penalty 
        or proceeding under subsection (a) of such section.
            (3) Subsequent violations.--After imposing a civil money 
        penalty under paragraph (2) against a hospital, if the 
        Secretary determines that the hospital subsequently and 
        knowingly violates subsection (a), the Secretary may issue an 
        order disqualifying the hospital from participation in the 
        programs under titles XVIII and XIX of the Social Security Act 
        and from receipt of Federal funds under any grant or 
        cooperative agreement for such period as the Secretary 
        specifies and until the Secretary receives satisfactory 
        assurances that the hospital will be in substantial compliance 
        with the requirement of subsection (a).
            (4) Failure to submit or comply with remedial plan.--If the 
        Secretary determines, after consultation with the HHS Inspector 
        General, that a hospital has failed to submit a satisfactory 
        remedial plan required under paragraph (2)(B) or is failing to 
        substantially carry out such a plan, the Secretary may suspend 
        payment of funds to the hospital under titles XVIII and XIX of 
        the Social Security Act and under Federal grants or cooperative 
        agreements until the Secretary receives satisfactory assurances 
        that such failures will not continue.
    (d) Effective Date.--This section shall take effect on the first 
day of the first month that begins more than 180 days after the date of 
the enactment of this Act.
Physician Availability Act of 1999 - Requires each non-Federal hospital with a specified participation agreement under title XVIII (Medicare) of the Social Security Act, participating under title XIX (Medicaid) of such Act, or receiving Federal funds, and with at least 100 licensed beds, to have a qualified physician available in the hospital (other than in the emergency department) 24 hours a day, seven days a week to attend to the hospital's inpatients.  Provides for enforcement, including through civil penalties and suspension or disqualification from Medicare or Medicaid.
Physician Availability Act of 1999