119th (2025–2027)
H.R. 3134
H.R. 3134 would extend Medicare and Medicaid coverage to freestanding emergency centers (FECs)—independent emergency departments that operate 24/7 with physicians and nurses on-site—making their coverage permanent after a temporary pandemic-era waiver expires. The bill affects Medicare beneficiaries and Medicaid enrollees who use these facilities, as well as the FECs themselves, which are primarily located in Texas and have reportedly saved Medicare 21.8 percent on emergency care costs compared to traditional hospital emergency rooms. FECs would be eligible under the same conditions as before, with most existing facilities grandfathered in while new facilities must be in rural counties without nearby Medicare-certified hospitals. The legislation applies immediately upon enactment and includes requirements that FECs comply with state licensing standards, maintain quality improvement programs, and follow the same patient protection rules as hospital emergency departments, including EMTALA obligations to treat all patients regardless of ability to pay.