II 109th CONGRESS 2d Session S. 3727 IN THE SENATE OF THE UNITED STATES July 25, 2006 Mr. Kohl 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 provide for an adjustment to the reduction of Medicare resident positions based on settled cost reports.

1.

Short title

This Act may be cited as the Medicare Residency Program Fairness Act of 2006.

2.

Adjustment to the reduction of Medicare resident positions based on settled cost reports

(a)

In general

Section 1886(h)(7) of the Social Security Act (42 U.S.C. 1395ww(h)(7)) is amended— (1)by redesignating subparagraph (D) as subparagraph (E); and (2)by adding at the end the following new subparagraph: (D)

Adjustment based on settled cost report for rural and small urban hospitals

In the case of a hospital located in a rural area (as defined in subsection (d)(2)(D)) or in an urban area that is not a large urban area (as so defined) for which— (i)the otherwise applicable resident limit was reduced under subparagraph (A)(i)(I); and (ii)such reduction was based on a reference resident level that was determined using a cost report that was subsequently settled, whether as a result of an appeal or otherwise, and the reference resident level under such settled cost report is higher than the level used for the reduction under subparagraph (A)(i)(I); the Secretary shall apply subparagraph (A)(i)(I) using the higher resident reference level and make any necessary adjustments to the reduction described in subclause (II). Any such necessary adjustments shall be effective for portions of cost reporting periods occurring on or after July 1, 2005.. (b)

Effective date

The amendments made by this section 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).