[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 588 Introduced in Senate (IS)]







110th CONGRESS
  1st Session
                                 S. 588

    To amend title XVIII of the Social Security Act to increase the 
Medicare caps on graduate medical education positions for States with a 
                         shortage of residents.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 14, 2007

Mr. Nelson of Florida (for himself, Mr. Reid, and Mr. Biden) 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 increase the 
Medicare caps on graduate medical education positions for States with a 
                         shortage of residents.

    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 ``Resident Physician Shortage 
Reduction Act of 2007''.

SEC. 2. INCREASING THE MEDICARE CAPS ON GRADUATE MEDICAL EDUCATION 
              POSITIONS FOR STATES WITH A SHORTAGE OF RESIDENTS.

    (a) Direct Graduate Medical Education.--Section 1886(h)(4)(F) of 
the Social Security Act (42 U.S.C. 1395ww(h)(4)(F)) is amended--
            (1) in clause (i), by inserting ``clause (iii) and'' after 
        ``subject to''; and
            (2) by adding at the end the following new clause:
                            ``(iii) Increase in caps on graduate 
                        medical education positions for states with a 
                        shortage of residents.--
                                    ``(I) In general.--For cost 
                                reporting periods beginning on or after 
                                the date that is 16 months after the 
                                date of enactment of the Resident 
                                Physician Shortage Reduction Act of 
                                2007, the Secretary shall increase the 
                                otherwise applicable limit on the total 
                                number of full-time equivalent 
                                residents in the field of allopathic or 
                                osteopathic medicine determined under 
                                clause (i) with respect to a qualifying 
                                hospital in an eligible State by an 
                                amount determined appropriate by the 
                                Secretary. Such increase shall be 
                                phased-in over a period of 5 cost 
                                reporting periods beginning with the 
                                first cost reporting period in which 
                                the increase is applied under the 
                                previous sentence to the hospital. For 
                                each eligible State the aggregate 
                                number of such increases shall be--
                                            ``(aa) not less than 15; 
                                        and
                                            ``(bb) not greater than the 
                                        State resident cap increase.
                                    ``(II) Qualifying hospital.--In 
                                this clause, the term `qualifying 
                                hospital' means a hospital located in 
                                an eligible State that the Secretary 
                                determines should receive an increase 
                                under this clause in the otherwise 
                                applicable limit on the total number of 
                                full-time equivalent residents in the 
                                field of allopathic or osteopathic 
                                medicine.
                                    ``(III) Eligible state.--In this 
                                clause, the term `eligible State' means 
                                a State for which the National median 
                                medical resident ratio exceeds the 
                                State medical resident ratio.
                                    ``(IV) State resident cap 
                                increase.--In this clause, the term 
                                `State resident cap increase' means, 
                                with respect to a State, \1/4\ of the 
                                product of--
                                            ``(aa) the difference 
                                        between the National median 
                                        medical resident ratio and the 
                                        State medical resident ratio; 
                                        and
                                            ``(bb) the State population 
                                        (as determined for purposes of 
                                        subclause (VI)).
                                    ``(V) National median medical 
                                resident ratio.--In this clause, the 
                                term `National median medical resident 
                                ratio' means the median of all State 
                                medical resident ratios.
                                    ``(VI) State medical resident 
                                ratio.--In this clause, the term `State 
                                medical resident ratio' means, with 
                                respect to any State, the ratio of 
                                full-time equivalent residents in the 
                                State in approved medical residency 
                                training programs as of the date of 
                                enactment of the Resident Physician 
                                Shortage Reduction Act of 2007 to the 
                                population of the State as of such 
                                date, as determined by the Secretary.
                                    ``(VII) State.--In this clause, the 
                                term `State' means a State and the 
                                District of Columbia.
                                    ``(VIII) Considerations in 
                                determining resident cap increases.--In 
                                determining whether a hospital is a 
                                qualifying hospital, and how much of an 
                                increase in the resident cap a 
                                qualifying hospital shall receive under 
                                subclause (I), the Secretary shall take 
                                into consideration the demonstrated 
                                likelihood of the hospital filling 
                                resident positions that would be made 
                                available as a result of such increase 
                                within the first 3 cost reporting 
                                periods beginning on or after the date 
                                that is 16 months after the date of 
                                enactment of the Resident Physician 
                                Shortage Reduction Act of 2007. The 
                                Secretary shall also take into 
                                consideration whether the new resident 
                                positions will be in primary care, 
                                preventive medicine, or geriatrics 
                                programs.''.
    (b) Indirect Medical Education.--Section 1886(d)(5)(B) of the 
Social Security Act (42 U.S.C. 1395ww(d)(5)(B)) is amended by adding at 
the end the following new clause:
            ``(x) Clause (iii) of subsection (h)(4)(F) shall apply to 
        clause (v) in the same manner and for the same period as such 
        clause (iii) applies to clause (i) of such subsection.''.
                                 <all>