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<bill bill-stage="Introduced-in-House" bill-type="olc" dms-id="H2328084E9C7340FF885A505F2C1EF909" key="H" public-private="public"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
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<dc:title>115 HR 6056 IH: Advancing Medical Resident Training in Community Hospitals Act of 2018</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2018-06-08</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">115th CONGRESS</congress><session display="yes">2d Session</session><legis-num display="yes">H. R. 6056</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20180608">June 8, 2018</action-date><action-desc><sponsor name-id="G000583">Mr. Gottheimer</sponsor> (for himself, <cosponsor name-id="M001193">Mr. MacArthur</cosponsor>, <cosponsor name-id="P000096">Mr. Pascrell</cosponsor>, <cosponsor name-id="N000188">Mr. Norcross</cosponsor>, <cosponsor name-id="W000822">Mrs. Watson Coleman</cosponsor>, and <cosponsor name-id="L000567">Mr. Lance</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HWM00">Committee on Ways and Means</committee-name>, and in addition to the Committee on <committee-name committee-id="HIF00">Energy and Commerce</committee-name>, for a period to be subsequently determined by the Speaker, in each case for consideration of such
			 provisions as fall within the jurisdiction of the committee concerned</action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To amend title XVIII of the Social Security Act to establish rules for payment for graduate medical
			 education (GME) costs for hospitals that establish a new medical residency
			 training program after hosting resident rotators for short durations.</official-title></form>
	<legis-body id="H16343710761D4FE7B9D2A81BE553B98D" style="OLC">
 <section id="HB9CB7DF02ABF4AD4A9DF5A4F5F93BC0F" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Advancing Medical Resident Training in Community Hospitals Act of 2018</short-title></quote>.</text> </section><section id="H158940DF869C4684A5DD421E3711548A"><enum>2.</enum><header>Medicare GME treatment of hospitals establishing new medical residency training programs after hosting medical resident rotators for short durations</header> <subsection id="HC4FD3159B4AD47A79F894708CF11AAD7"><enum>(a)</enum><header>Redetermination of approved FTE resident amount</header><text>Section 1886(h)(2)(F) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww(h)(2)(F)</external-xref>) is amended—</text>
 <paragraph id="HCD97E6FBFEDD400F8947E09E4FA29B6A"><enum>(1)</enum><text>by inserting <quote>(i)</quote> before <quote>In the case of</quote>; and</text> </paragraph><paragraph id="H311CC02416954B77BA7AEF418B5D2529"><enum>(2)</enum><text>by adding at the end the following:</text>
					<quoted-block id="HB4EC5DFA91254059BEF77AE5A07B31F0" style="OLC">
 <clause id="H4C554BA1872546C486ADEDDAAF85CAF1"><enum>(ii)</enum><text>In applying this subparagraph to a hospital that has not entered into a GME affiliation agreement (as defined by the Secretary for purposes of paragraph (4)(H)(ii)), the Secretary shall not provide for the establishment of an FTE resident amount until such time as the Secretary determines that the hospital has a medical residency training program that trains more than 1.0 full-time-equivalent resident in a cost reporting period.</text>
 </clause><clause id="H346017B2565A487695AA8FBEBA6489D0"><enum>(iii)</enum><text>In the case of a hospital with an approved FTE resident amount—</text> <subclause id="H932E2CCF91C14CB08C34B34BD69BCB11"><enum>(I)</enum><text>based on the training of less than 1.0 full-time-equivalent resident before October 1, 1997, or</text>
 </subclause><subclause id="H4BC3C19840754278B869ABD5318C7B8E"><enum>(II)</enum><text>based on the training of no more than 3.0 full-time-equivalent residents in a new medical residency training program in any cost reporting period beginning on or after October 1, 1997, and before the date of the enactment of this clause, or</text>
 </subclause><subclause id="H9CA640363A504CF198D33CCF3B1056CB"><enum>(III)</enum><text>based on the training of no full-time-equivalent residents in a medical residency training program for any ten consecutive cost reporting periods beginning on or after October 1, 1997,</text>
							</subclause><continuation-text continuation-text-level="clause">the Secretary shall provide the hospital an opportunity to have a new FTE resident amount
			 established when the hospital begins training at least 1.0 full-time
			 equivalent resident (in the case of a hospital described in subclauses (I
			 or III)) or more than 3.0 full-time-equivalent residents (in the case of a
			 hospital described in subclause (II)) for cost reporting periods beginning
			 on or after the date of the enactment of this clause and in accordance
			 with the methodology under the rules in effect as of October 1, 2015.</continuation-text></clause><after-quoted-block>.</after-quoted-block></quoted-block>
 </paragraph></subsection><subsection id="HE8295306CECE4535B87A79769DC5BD20"><enum>(b)</enum><header>Redetermination of FTE resident limitation</header><text>Section 1886(h)(4)(H)(i) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww(h)(4)(H)(i)</external-xref>) is amended—</text> <paragraph id="HC03D7ADE96DD4426920A1A3943624CD4"><enum>(1)</enum><text>by inserting <quote>(I)</quote> before <quote>The Secretary</quote>; and</text>
 </paragraph><paragraph id="H43841A5835D14D78ADA28400B1E3D8CA"><enum>(2)</enum><text>by adding at the end the following:</text> <quoted-block id="HEBA707595555475DBB5C56953567D0F9" style="OLC"> <subclause id="H05994200EF8E44AEA814EDA891BFA5E3"><enum>(II)</enum><text>Under this clause the Secretary shall not determine an adjustment in the limitation applicable to a hospital under subparagraph (F) until the hospital trains more than 1.0 full-time equivalent resident in a new medical residency training program in a cost reporting period.</text>
 </subclause><subclause id="H96FEF870D8D744F49414020B8CAE02D3"><enum>(III)</enum><text>In the case of a hospital that has a limitation under subparagraph (F) of less than 1.0 full-time-equivalent resident as of the date of the enactment of this subclause based on training before October 1, 1997, under this clause the Secretary shall provide the hospital an opportunity to have a new adjustment in such limitation determined when such hospital begins training at least 1.0 full-time equivalent resident in accordance with the methodology applicable to hospitals under the rules in effect as of October 1, 2015, and applied for cost reporting periods beginning on or after the date of the enactment of this subclause.</text>
 </subclause><subclause id="H7BDF55B9AE184B28B4A9BB4269B9FCA5"><enum>(IV)</enum><text>In the case of a hospital that has not reported full-time-equivalent residents in ten consecutive cost reporting periods subsequent to October 1, 1997, under this clause the Secretary shall provide the hospital an opportunity to have a new adjustment in such limitation determined when such hospital begins training at least 1.0 full-time equivalent resident in accordance with the methodology applicable to hospitals under the rules in effect as of October 1, 2015, and applied for cost reporting periods beginning on or after the date of the enactment of this subclause.</text>
 </subclause><subclause id="H05BF2580114B4F8E86399638006879E9"><enum>(V)</enum><text>In the case of a hospital for which an adjustment in the limitation applicable to a hospital under subparagraph (F) is based on the training of no more than 3.0 full-time-equivalent residents in a new medical residency training program in a cost reporting period beginning on or after October 1, 1997, and before the date of the enactment of this subclause, the Secretary shall provide the hospital an opportunity to have a new adjustment in such limitation determined when the hospital begins training more than 3.0 full-time-equivalent residents in accordance with the methodology applicable to hospitals under the rules in effect as of October 1, 2015, and applied for cost reporting periods beginning on or after the date of the enactment of this subclause.</text></subclause><after-quoted-block>.</after-quoted-block></quoted-block>
 </paragraph></subsection><subsection id="HE3CA4A8B9E824A2C90A1496B6BF80CFF"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section shall apply to payment under section 1886 of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww</external-xref>) for cost reporting periods beginning on or after the date of the enactment of this Act.</text>
			</subsection></section></legis-body></bill>


