[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1928 Introduced in House (IH)]







107th CONGRESS
  1st Session
                                H. R. 1928

  To amend title XVIII of the Social Security Act to provide for full 
payment rates under Medicare to hospitals for costs of direct graduate 
   medical education of residents for residency training programs in 
 specialties or subspecialties which the Secretary of Health and Human 
Services designates as critical need specialty or subspecialty training 
                               programs.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 21, 2001

  Mr. Stark (for himself, Mr. Rangel, Mr. Matsui, Mr. McDermott, Mr. 
Lewis of Georgia, Mrs. Thurman, Mr. Waxman, Mr. Bonior, Mr. Frost, Ms. 
Kaptur, Mr. Filner, Mr. Hilliard, Mr. Rush, Mr. Bentsen, Mr. Cummings, 
   Ms. Jackson-Lee of Texas, Mr. Davis of Illinois, and Ms. Berkley) 
 introduced the following bill; which was referred to the Committee on 
    Ways and Means, and in addition to the Committee on Energy and 
Commerce, 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

_______________________________________________________________________

                                 A BILL


 
  To amend title XVIII of the Social Security Act to provide for full 
payment rates under Medicare to hospitals for costs of direct graduate 
   medical education of residents for residency training programs in 
 specialties or subspecialties which the Secretary of Health and Human 
Services designates as critical need specialty or subspecialty training 
                               programs.

    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 ``Medicare Critical Need GME 
Protection Act of 2001''.

SEC. 2. FULL FTE PAYMENT FOR RESIDENTS IN CRITICAL NEED SPECIALTY OR 
              SUBSPECIALTY TRAINING PROGRAMS.

    (a) Treatment as Initial Residency Period.--
            (1) In general.--Section 1886(h)(5)(F) of the Social 
        Security Act (42 U.S.C. 1395ww(h)(5)(F)) is amended--
                    (A) in clause (i)--
                            (i) by striking ``clause (ii)'' and 
                        inserting ``clauses (ii) and (iii)''; and
                            (ii) by striking ``and'' at the end;
                    (B) in clause (ii), by striking the period at the 
                end and inserting ``, and''; and
                    (C) by inserting after clause (ii) the following 
                new clause:
                            ``(iii) subject to the requirement for 
                        budget neutrality under paragraph (7), a period 
                        of years during which an individual is in a 
                        residency training program designated by the 
                        Secretary as a critical need specialty or 
                        subspecialty, as defined in subparagraph 
                        (K)(i), shall be treated as part of the initial 
                        residency period, but shall not be counted 
                        against any limitation on the initial residency 
                        period.''.
            (2) Determination of critical need specialty or 
        subspecialty.--Section 1886(h)(5) of such Act (42 U.S.C. 
        1395ww(h)(5)) is amended by adding at the end the following new 
        subparagraph:
                    ``(K) Critical need speciality.--
                            ``(i) Definition.--The term `critical need 
                        specialty or subspecialty' means a specialty or 
                        subspecialty designated by the Secretary under 
                        this subparagraph with a current or imminent 
                        critical shortage of physicians.
                            ``(ii) Criteria.--For purposes of 
                        designating a critical need specialty or 
                        subspecialty under this subparagraph, the 
                        Secretary shall prescribe criteria for 
                        determining critical shortages of physicians or 
                        residents in approved medical residency 
                        training programs. The Secretary shall publish 
                        in the Federal Register the criteria 
                        established under this clause and the form and 
                        manner by which data are submitted for the 
                        Secretary's review under this subparagraph.
                            ``(iii) Period of designation.--
                                    ``(I) In general.--A designation of 
                                a critical need specialty or 
                                subspecialty under this subparagraph 
                                shall apply beginning with the first 
                                residency training year in which it is 
                                effective and shall continue until the 
                                first residency training year for which 
                                Secretary determines the specialty or 
                                subspecialty does not meet the criteria 
                                for designation as a critical need 
                                specialty or subspecialty.
                                    ``(II) Report.--If the Secretary 
                                determines that a specialty or 
                                subspecialty no longer meets the 
                                criteria for being a critical need 
                                specialty or subspecialty, the 
                                Secretary shall submit a report to 
                                Congress describing the reasons for 
                                discontinuing the designation.''.
    (b) Maintaining Budget Neutrality.--Section 1886(h) of such Act (42 
U.S.C. 1395ww(h)) is amended by adding at the end the following new 
paragraph:
    ``(7) Budget neutrality adjustment for critical need specialty or 
subspecialty designation.--If the Secretary designates a critical need 
specialty or subspecialty for a residency training year, the Secretary 
shall make a proportional adjustment to payment amounts under this 
subsection for such residency training year so that the aggregate of 
the payments under this subsection for the portions of such residency 
training year occurring in any fiscal year shall equal the aggregate 
payments that would have been made under this subsection for such 
portions of the fiscal year if the Secretary had not designated a 
critical need specialty or subspecialty.''.
    (c) Effective Date.--The amendments made by this section shall 
apply with respect to payments under section 1886(h) of the Social 
Security Act (42 U.S.C. 1395ww(h)) made for periods in a residency 
training program for residency training years beginning on or after on 
or after July 1, 2002.
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