An Act amending the act of July 19, 1979 (P.L.130, No.48), known as the Health Care Facilities Act, providing for onsite emergency physicians.

PRIOR PRINTER'S NO. 2963 PRINTER'S NO. 3090
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 2265
Session of
2026
INTRODUCED BY TAKAC, PICKETT, VENKAT, HILL-EVANS, GUZMAN,
DELLOSO, K. HARRIS AND CEPEDA-FREYTIZ, MARCH 4, 2026
AS REPORTED FROM COMMITTEE ON HEALTH, HOUSE OF REPRESENTATIVES,
AS AMENDED, MARCH 25, 2026
AN ACT
Amending the act of July 19, 1979 (P.L.130, No.48), entitled "An
act relating to health care; prescribing the powers and
duties of the Department of Health; establishing and
providing the powers and duties of the State Health
Coordinating Council, health systems agencies and Health Care
Policy Board in the Department of Health, and State Health
Facility Hearing Board in the Department of Justice;
providing for certification of need of health care providers
and prescribing penalties," providing for onsite emergency
physicians.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of July 19, 1979 (P.L.130, No.48), known
as the Health Care Facilities Act, is amended by adding a
chapter to read:
CHAPTER 8-D
ONSITE EMERGENCY PHYSICIANS
Section 801-D. Definitions.
The following words and phrases when used in this chapter
shall have the meanings given to them in this section unless the
context clearly indicates otherwise:
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"Board-certified emergency physician." A physician licensed
under the act of October 5, 1978 (P.L.1109, No.261), known as
the Osteopathic Medical Practice Act, or the act of December 20,
1985 (P.L.457, No.112), known as the Medical Practice Act of
1985, who is certified in the specialty of emergency medicine by
a board recognized by the American Board of Medical Specialties
or the American Osteopathic Association.
"Board-eligible emergency physician." A physician who:
(1) is licensed under the Medical Practice Act of 1985
or the Osteopathic Medical Practice Act;
(2) has completed a residency in emergency medicine
accredited by the Accreditation Council for Graduate Medical
Education or the American Osteopathic Association; and
(3) remains within the eligibility period to sit for
initial board certification in emergency medicine as
established by the relevant certifying board.
"Emergency department." The designated area of a hospital
where health care services are furnished to evaluate, treat and
stabilize a condition manifesting by acute symptoms of
sufficient severity, including severe pain, such that the
absence of immediate medical attention could reasonably be
expected to result in placing the individual's health, or the
health of an unborn child, in serious jeopardy, serious
impairment to bodily functions or serious dysfunction of any
bodily organ.
"Hospital." A health care facility that is primarily engaged
in providing to inpatients, by or under supervision of
physicians, diagnostic services and therapeutic services for
medical diagnosis, treatment and care of individuals who are
injured, disabled or sick or rehabilitation services for the
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rehabilitation of individuals who are injured, disabled or sick.
"EMERGENCY DEPARTMENT." AS DEFINED IN SECTION 2 OF THE ACT
OF NOVEMBER 2, 2016 (P.L.976, NO.122), KNOWN AS THE SAFE
EMERGENCY PRESCRIBING ACT.
"EMERGENCY PHYSICIAN." A PHYSICIAN WHO HAS COMPLETED
POSTGRADUATE TRAINING IN EMERGENCY MEDICINE, INCLUDING PEDIATRIC
EMERGENCY MEDICINE, OR WHO POSSESSES QUALIFICATIONS, TRAINING OR
EXPERIENCE IN EMERGENCY MEDICINE, INCLUDING PEDIATRIC EMERGENCY
MEDICINE, AS DETERMINED APPROPRIATE BY A HOSPITAL'S MEDICAL
STAFF AND GOVERNING BODY.
"HOSPITAL." AS DEFINED IN SECTION 802.1.
"Onsite." In relation to services, that the services are:
(1) being provided to a patient who is physically
present in an emergency department; and
(2) immediately available to the individual being
supervised and with continued involvement in appropriate
components of care.
"Physician." A medical doctor or doctor of osteopathy.
EITHER:
(1) AS DEFINED IN SECTION 2 OF THE ACT OF OCTOBER 5,
1978 (P.L.1109, NO.261), KNOWN AS THE OSTEOPATHIC MEDICAL
PRACTICE ACT; OR
(2) AS DEFINED IN SECTION 2 OF THE ACT OF DECEMBER 20,
1985 (P.L.457, NO.112), KNOWN AS THE MEDICAL PRACTICE ACT OF
1985.
Section 802-D. Requirement for onsite emergency physician.
Unless an exception has been approved under section 803-D, a
hospital with an emergency department shall ensure that a board-
certified AN emergency physician or board-eligible emergency
physician is onsite, on duty and primarily responsible for the
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emergency department at all times when the emergency department
is open.
Section 803-D. Exception.
(a) Power of department.--The department may grant an
exception to the requirements of section 802-D if a hospital is
located in an area not designated as an urbanized area by the
United States Census Bureau, including an area designated as an
urban cluster, and satisfies the eligibility conditions in
subsection (b).
(A) POWER OF DEPARTMENT.--
(1) THE DEPARTMENT MAY GRANT AN EXCEPTION TO THE
REQUIREMENTS OF SECTION 802-D IF A HOSPITAL SATISFIES THE
ELIGIBILITY CONDITIONS IN SUBSECTION (B).
(2) AN EXCEPTION GRANTED UNDER THIS SUBSECTION SHALL
PERMIT A HOSPITAL TO STAFF ITS EMERGENCY DEPARTMENT WITH A
PHYSICIAN WHO IS ONSITE AND ON DUTY AT ALL TIMES THE
EMERGENCY DEPARTMENT IS OPEN, REGARDLESS OF THE PHYSICIAN'S
QUALIFICATIONS, TRAINING OR EXPERIENCE IN EMERGENCY MEDICINE.
(b) Eligibility.--To qualify for the exception under
subsection (a), a hospital must demonstrate to the department
the following conditions:
(1) The hospital has an average daily emergency
department census of 46 or less visits over the preceding two
years.
(2) Documented good faith efforts to recruit and retain
board-certified emergency physicians or board-eligible
emergency physicians.
(3) Any other condition determined by the department
that is necessary to protect patient safety, including:
(i) Written policies for transfer of patients
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requiring care beyond the capabilities of the hospital.
(ii) Maintenance of transfer agreements consistent
with 42 U.S.C. § 1395dd (relating to examination and
treatment for emergency medical conditions and women in
labor).
(c) Process for review of exceptions.--The department shall
process an exception under subsection (a) in accordance with 28
Pa. Code §§ 51.31 (relating to principle), 51.32 (relating to
exceptions for innovative programs), 51.33 (relating to requests
for exceptions) and 51.34 (relating to revocation of
exceptions). AND DOCUMENT TO THE DEPARTMENT GOOD FAITH EFFORTS
TO RECRUIT AND RETAIN EMERGENCY PHYSICIANS.
Section 804-D. Construction.
Nothing (A) TELE-EMERGENCY DEPARTMENT MODEL.--EXCEPT AS
PROVIDED UNDER SUBSECTION (B), NOTHING in this chapter shall be
construed to authorize the use of a tele-emergency department
model in lieu of the requirement for an onsite physician under
section 802-D.
(B) PRIOR EXCEPTIONS.--AN EXCEPTION THAT HAS BEEN GRANTED BY
THE DEPARTMENT FOR USE OF A TELE-EMERGENCY DEPARTMENT MODEL OR
USE OF ONSITE HEALTH CARE PRACTITIONERS, OTHER THAN PHYSICIANS
IN AN EMERGENCY DEPARTMENT PRIOR TO THE EFFECTIVE DATE OF THIS
SUBSECTION, SHALL REMAIN IN FULL FORCE AND EFFECT UNTIL
RESCINDED BY THE DEPARTMENT.
Section 2. This act shall take effect in 60 days.
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