[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5574 Enrolled Bill (ENR)]


        H.R.5574

                       One Hundred Ninth Congress

                                 of the

                        United States of America


                          AT THE SECOND SESSION

          Begun and held at the City of Washington on Tuesday,
             the third day of January, two thousand and six


                                 An Act


 
   To amend the Public Health Service Act to reauthorize support for 
      graduate medical education programs in children's hospitals.

    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 ``Children's Hospital GME Support 
Reauthorization Act of 2006''.

SEC. 2. PROGRAM OF PAYMENTS TO CHILDREN'S HOSPITALS THAT OPERATE 
              GRADUATE MEDICAL EDUCATION PROGRAMS.

    (a) In General.--Section 340E of the Public Health Service Act (42 
U.S.C. 256e) is amended--
        (1) in subsection (a), by inserting ``and each of fiscal years 
    2007 through 2011'' after ``for each of fiscal years 2000 through 
    2005'';
        (2) in subsection (e)(1), by striking ``26'' and inserting 
    ``12'';
        (3) in subsection (f)(1)(A)--
            (A) in clause (ii), by striking ``and'' at the end;
            (B) in clause (iii), by striking the period at the end and 
        inserting ``; and''; and
            (C) by adding at the end the following:
                ``(iv) for each of fiscal years 2007 through 2011, 
            $110,000,000.''; and
        (4) in subsection (f)(2)--
            (A) in the matter before subparagraph (A), by striking 
        ``subsection (b)(1)(A)'' and inserting ``subsection 
        (b)(1)(B)'';
            (B) in subparagraph (B), by striking ``and'' at the end;
            (C) in subparagraph (C), by striking the period at the end 
        and inserting ``; and''; and
            (D) by adding at the end the following:
            ``(D) for each of fiscal years 2007 through 2011, 
        $220,000,000.''.
    (b) Reduction in Payments for Failure To File Annual Report.--
Subsection (b) of section 340E of the Public Health Service Act (42 
U.S.C. 256e) is amended--
        (1) in paragraph (1), in the matter before subparagraph (A), by 
    striking ``paragraph (2)'' and inserting ``paragraphs (2) and 
    (3)''; and
        (2) by adding at the end the following:
        ``(3) Annual reporting required.--
            ``(A) Reduction in payment for failure to report.--
                ``(i) In general.--The amount payable under this 
            section to a children's hospital for a fiscal year 
            (beginning with fiscal year 2008 and after taking into 
            account paragraph (2)) shall be reduced by 25 percent if 
            the Secretary determines that--

                    ``(I) the hospital has failed to provide the 
                Secretary, as an addendum to the hospital's application 
                under this section for such fiscal year, the report 
                required under subparagraph (B) for the previous fiscal 
                year; or
                    ``(II) such report fails to provide the information 
                required under any clause of such subparagraph.

                ``(ii) Notice and opportunity to provide missing 
            information.--Before imposing a reduction under clause (i) 
            on the basis of a hospital's failure to provide information 
            described in clause (i)(II), the Secretary shall provide 
            notice to the hospital of such failure and the Secretary's 
            intention to impose such reduction and shall provide the 
            hospital with the opportunity to provide the required 
            information within a period of 30 days beginning on the 
            date of such notice. If the hospital provides such 
            information within such period, no reduction shall be made 
            under clause (i) on the basis of the previous failure to 
            provide such information.
            ``(B) Annual report.--The report required under this 
        subparagraph for a children's hospital for a fiscal year is a 
        report that includes (in a form and manner specified by the 
        Secretary) the following information for the residency academic 
        year completed immediately prior to such fiscal year:
                ``(i) The types of resident training programs that the 
            hospital provided for residents described in subparagraph 
            (C), such as general pediatrics, internal medicine/
            pediatrics, and pediatric subspecialties, including both 
            medical subspecialties certified by the American Board of 
            Pediatrics (such as pediatric gastroenterology) and non-
            medical subspecialties approved by other medical 
            certification boards (such as pediatric surgery).
                ``(ii) The number of training positions for residents 
            described in subparagraph (C), the number of such positions 
            recruited to fill, and the number of such positions filled.
                ``(iii) The types of training that the hospital 
            provided for residents described in subparagraph (C) 
            related to the health care needs of different populations, 
            such as children who are underserved for reasons of family 
            income or geographic location, including rural and urban 
            areas.
                ``(iv) The changes in residency training for residents 
            described in subparagraph (C) which the hospital has made 
            during such residency academic year (except that the first 
            report submitted by the hospital under this subparagraph 
            shall be for such changes since the first year in which the 
            hospital received payment under this section), including--

                    ``(I) changes in curricula, training experiences, 
                and types of training programs, and benefits that have 
                resulted from such changes; and
                    ``(II) changes for purposes of training the 
                residents in the measurement and improvement of the 
                quality and safety of patient care.

                ``(v) The numbers of residents described in 
            subparagraph (C) who completed their residency training at 
            the end of such residency academic year and care for 
            children within the borders of the service area of the 
            hospital or within the borders of the State in which the 
            hospital is located. Such numbers shall be disaggregated 
            with respect to residents who completed residencies in 
            general pediatrics or internal medicine/pediatrics, 
            subspecialty residencies, and dental residencies.
            ``(C) Residents.--The residents described in this 
        subparagraph are those who--
                ``(i) are in full-time equivalent resident training 
            positions in any training program sponsored by the 
            hospital; or
                ``(ii) are in a training program sponsored by an entity 
            other than the hospital, but who spend more than 75 percent 
            of their training time at the hospital.
            ``(D) Report to congress.--Not later than the end of fiscal 
        year 2011, the Secretary, acting through the Administrator of 
        the Health Resources and Services Administration, shall submit 
        a report to the Congress--
                ``(i) summarizing the information submitted in reports 
            to the Secretary under subparagraph (B);
                ``(ii) describing the results of the program carried 
            out under this section; and
                ``(iii) making recommendations for improvements to the 
            program.''.
    (c) Technical Amendments.--Section 340E of the Public Health 
Service Act (42 U.S.C. 256e) is further amended--
        (1) in subsection (c)(2)(E)(ii), by striking ``described in 
    subparagraph (C)(ii)'' and inserting ``applied under section 
    1886(d)(3)(E) of the Social Security Act for discharges occurring 
    during the preceding fiscal year'';
        (2) in subsection (e)(2), by striking the first sentence; and
        (3) in subsection (e)(3), by striking ``made to pay'' and 
    inserting ``made and pay''.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.