; (2) in subparagraph (J), by striking the period at the end and inserting ; and ; and (3) by adding at the end the following new subparagraph: (K) emergency services (as defined in section 2799A–1(a)(3)(C) of the Public Health Service Act) provided by a freestanding emergency center (as defined in section 1861(nnn)). . (b) Freestanding emergency center defined Section 1861 of the Social Security Act ( 42 U.S.C. 1395x ) is amended by adding at the end the following new subsection: (nnn) Freestanding emergency center The term freestanding emergency center means a health care facility that— (1) is an independent freestanding emergency department (as defined in section 2799A–1(a)(3)(D) of the Public Health Service Act); (2) is operational 24 hours a day, 7 days a week, and 365 days a year with a physician (as defined in subsection (r)) onsite and available at all times; (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) is located— (A) in a metropolitan statistical area; or (B) (i) in the case of a facility established prior to 2020, in a rural county; or (ii) in the case of a facility established on or after January 1, 2020, in a rural county that does not have a Medicare-certified hospital or a rural emergency hospital (as defined in subsection (kkk)(2)); (6) has established a governing body to determine, implement, and monitor policies governing the total operation of the facility, and has oversight and accountability for the QAPI program, ensuring that facility policies and such QAPI program are administered so as to provide quality health care in a safe environment