; (3) has in place mechanisms to allow for appropriate transfers and referrals; (4) develops, implements, and maintains an ongoing, data-driven quality assessment and performance improvement (QAPI) program; (5) establishes a governing body that assumes full legal responsibility for determining, implementing, and monitoring policies governing the total operation of the facility and has oversight and accountability for the quality assessment and performance improvement program, ensuring that facility policies and the program are administered so as to provide quality health care in a safe environment; and (6) has a written agreement with the Secretary to provide emergency medical services to beneficiaries. . (c) Medicare payment and certain reporting Section 1833(t)(21) of the Social Security Act ( 42 U.S.C. 1395l(t)(21) ) is amended by adding at the end the following new subparagraphs: (F) Treatment of freestanding emergency centers The facility payment rate for services of a freestanding emergency center (as defined in section 1861(jjj)) for higher acuity evaluation or management level services (represented by HCPCS codes 99283–99285) shall be an amount equal to— (i) in the case of services furnished by such a center in an urban area, 75 percent of the amount of payment that would otherwise apply under this subsection, including application of the geographic adjustment under paragraph (2)(D) and the OPD fee schedule increase factor under paragraph (3)(C)(iv)