Page:United States Statutes at Large Volume 103 Part 3.djvu/179

 PUBLIC LAW 101-239—DEC. 19, 1989 103 STAT. 2247 (2) by striking "with appropriate medical records" and all that follows through "transferring hospital" and inserting "all medical records (or copies thereof), related to the emergency condition for which the individual has presented, available at the time of the transfer, including records related to the individ- ual's emergency medical condition, observations of signs or • symptoms, preliminary diagnosis, treatment provided, results of any tests and the informed written consent or certification (or copy thereof) provided under pars^aph (I)(A), and the name and address of any on-call physician (described in subsection (d)(2)(C)) who has refused or failed to appear within a reasonable time to provide necessary stabilizing treatment". (e) PHYSICIAN LIABILITY.—Subsection (d)(2) of such subsection is amended— (1) by amending subparagraph (B) to read as follows: "(B) Subject to subparagraph (C), any physician who is respon- sible for the examination, treatment, or transfer of an individ- ual in a participating hospital, including a physician on-call for the care of such an individual, and who knowingly violates a requirement of this section, including a physiciein who— "(i) signs a certification under subsection (c)(l)(A) that the , medical benefits reasonably to be expected from a transfer to another facility outweigh the risks associated with the transfer, if the physician knew or should have known that the benefits did not outweigh the risks, or "(ii) misrepresents an individual's condition or other information, including a hospital's obligations under this section, is subject to a civil money penalty of not more than $50,000 for each such violation and, if the violation is knowing and willful or negligent, to exclusion from participation in this title and State health care programs. The provisions of section 1128A (other than the first and second sentences of subsection (a) and subsection (b)) shall apply to a civil money penalty and exclu- sion under this subparagraph in the same manner as such provisions apply with respect to a penalty, exclusion, or proceed- ing under section 1128A(a)."; and (2) by striking subparagraph (C) and inserting the following: "(C) If, after an initial examination, a physician determines that the individual requires the services of a physician listed by the hospital on its list of on-call physicians (required to be maintained under section 1866(a)(l)(I)) and notifies the on-call physician and the on-call physician fails or refuses to appear within a reasonable period of time, and the physician orders the transfer of the individual because the physician determines that without the services of the on-call physician the benefits of transfer outweigh the risks of transfer, the physician authoriz- ing the transfer shall not be subject to a penalty under subpara- graph (B). However, the previous sentence shall not apply to the hospital or to the on-call physician who failed or refused to appear.". (f) ADDITIONAL OBLIGATIONS. — Such section is amended by adding at the end the following new subsections: "(g) NONDISCRIMINATION. — A participating hospital that has specialized capabilities or facilities (such as burn units, shock-

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