[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 541 Introduced in Senate (IS)]







106th CONGRESS
  1st Session
                                 S. 541

To amend title XVIII of the Social Security Act to make certain changes 
 related to payments for graduate medical education under the Medicare 
                                Program.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 4, 1999

 Ms. Collins (for herself, Mr. Murkowski, and Mr. Roberts) introduced 
the following bill; which was read twice and referred to the Committee 
                               on Finance

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to make certain changes 
 related to payments for graduate medical education under the Medicare 
                                Program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Graduate Medical Education Technical 
Amendments of 1999''.

SEC. 2. INDIRECT GRADUATE MEDICAL EDUCATION ADJUSTMENT.

    (a) In General.--Section 1886(d)(5)(B)(v) of the Social Security 
Act (42 U.S.C. 1395ww(d)(5)(B)(v)) (as added by section 4621(b) of the 
Balanced Budget Act of 1997) is amended--
            (1) by striking ``(v) In determining'' and inserting 
        ``(v)(I) Subject to subclause (II), in determining'';
            (2) by striking ``in the hospital with respect to the 
        hospital's most recent cost reporting period ending on or 
        before December 31, 1996''; and inserting ``who were appointed 
        by the hospital's approved medical residency training programs 
        for the hospital's most recent cost reporting period ending on 
        or before December 31, 1996''; and
            (3) by adding at the end the following:
    ``(II) Beginning on or after January 1, 1997, in the case of a 
hospital that sponsors only 1 allopathic or osteopathic residency 
program, the limit determined for such hospital under subclause (I) 
may, at the hospital's discretion, be increased by 1 for each calendar 
year but shall not exceed a total of 3 more than the limit determined 
for the hospital under subclause (I).''.
    (b) Technical Amendments.--Section 1886(d)(5)(B) of the Social 
Security Act (42 U.S.C. 1395ww(d)(5)(B)) is amended by moving clauses 
(ii), (v), and (vi) 2 ems to the left.

SEC. 3. DIRECT GRADUATE MEDICAL EDUCATION ADJUSTMENT.

    (a) Limitation on Number of Residents.--Section 1886(h)(4)(F) of 
the Social Security Act (42 U.S.C. 1395ww(h)(4)(F)) (as added by 
section 4623 of the Balanced Budget Act of 1997) is amended by 
inserting ``who were appointed by the hospital's approved medical 
residency training programs'' after ``may not exceed the number of such 
full-time equivalent residents''.
    (b) Funding for New Programs.--The first sentence of section 
1886(h)(4)(H)(i) of the Social Security Act (42 U.S.C. 
1395ww(h)(4)(H)(i)) (as added by section 4623 of the Balanced Budget 
Act of 1997) is amended by inserting ``and before September 30, 1999'' 
after ``January 1, 1995''.
    (c) Funding for Programs Meeting Rural Needs.--The second sentence 
of section 1886(h)(4)(H)(i) of the Social Security Act (42 U.S.C. 
1395ww(h)(4)(H)(i)) (as added by section 4623 of the Balanced Budget 
Act of 1997) is amended by striking the period at the end and inserting 
``, including facilities that are not located in an underserved rural 
area but have established separately accredited rural training 
tracks.''.

SEC. 4. EFFECTIVE DATE.

    The amendments made by this Act shall take effect as if included in 
the enactment of the Balanced Budget Act of 1997.
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