II 111th CONGRESS 1st Session S. 1300 IN THE SENATE OF THE UNITED STATES June 18, 2009 Ms. Snowe (for herself, Mr. Dorgan, and Ms. Collins) 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 clarify congressional intent regarding the counting of residents in a nonhospital setting under the Medicare program.

1.

Short title

This Act may be cited as the Community and Rural Medical Residency Preservation Act of 2009.

2.

Clarification of congressional intent regarding the counting of residents in a nonhospital setting

(a)

D–GME

Section 1886(h)(4)(E) of the Social Security Act (42 U.S.C. 1395ww(h)(4)(E)) is amended by adding at the end the following new sentences: For purposes of the preceding sentence, the term all, or substantially all, of the costs for the training program means the stipends and benefits provided to the resident and other amounts, if any, as determined by the hospital and the entity operating the nonhospital setting. The hospital is not required to pay the entity any amounts other than those determined by the hospital and the entity in order for the hospital to be considered to have incurred all, or substantially all, of the costs for the training program in that setting.. (b)

IME

Section 1886(d)(5)(B)(iv) of the Social Security Act (42 U.S.C. 1395ww(d)(5)(B)(iv)) is amended by adding at the end the following new sentences: For purposes of the preceding sentence, the term all, or substantially all, of the costs for the training program means the stipends and benefits provided to the resident and other amounts, if any, as determined by the hospital and the entity operating the nonhospital setting. The hospital is not required to pay the entity any amounts other than those determined by the hospital and the entity in order for the hospital to be considered to have incurred all, or substantially all, of the costs for the training program in that setting.. (c)

Effective date

The amendments made by this section shall take effect on January 1, 2010.