[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4039 Introduced in House (IH)]







109th CONGRESS
  1st Session
                                H. R. 4039

   To amend title XVIII of the Social Security Act to provide for an 
 exception to the reduction in unused medical residency positions for 
  small family practice residency programs under the Medicare Program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 7, 2005

    Mr. Green of Wisconsin introduced the following bill; which was 
              referred to the Committee on Ways and Means

_______________________________________________________________________

                                 A BILL


 
   To amend title XVIII of the Social Security Act to provide for an 
 exception to the reduction in unused medical residency positions for 
  small family practice residency programs 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. EXCEPTION TO THE MEDICARE REDUCTION IN UNUSED MEDICAL 
              RESIDENCY POSITIONS FOR SMALL FAMILY PRACTICE RESIDENCY 
              PROGRAMS.

    (a) In General.--Section 1886(h)(7)(A)(i) of the Social Security 
Act (42 U.S.C. 1395ww(h)(7)(A)(i)) is amended--
            (1) in subclause (I), by striking ``subclause (II)'' and 
        inserting ``subclauses (II) and (III)''; and
            (2) by adding at the end the following new subclause:
                                    ``(III) Exception for small family 
                                practice residency programs.--This 
                                subparagraph shall not apply to a 
                                hospital located in a rural area (as 
                                defined in subsection (d)(2)(D)(ii)) or 
                                a hospital located in an urban area 
                                that is not a large urban area (as 
                                defined for purposes of subsection (d)) 
                                with an osteopathic or allopathic 
                                family practice program where the 
                                number of residents included in the 
                                otherwise applicable resident limit 
                                does not exceed 20.''.
    (b) Budget Neutrality.--To the extent that payments for direct 
graduate medical education costs under subsection (h) of section 1886 
of the Social Security Act (42 U.S.C. 1395ww) and for the indirect 
medical education cost adjustment under subsection (d)(5)(B) of such 
section are increased as a result of the amendments made by subsection 
(a), the Secretary of Health and Human Services shall reduce the 
standardized amount calculated pursuant to subsection (d) of such 
section in such amount so that the aggregate expenditures under title 
XVIII of such Act are not increased as a result of such amendments.
    (c) Effective Date.--The amendments made by subsection (a) shall 
take effect as if included in the enactment of section 422 of the 
Medicare Prescription Drug, Improvement, and Modernization Act of 2003 
(Public Law 108-173).
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