II 111th CONGRESS 1st Session S. 852 IN THE SENATE OF THE UNITED STATES April 22, 2009 Mr. Vitter (for himself and Ms. Landrieu) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To apply an alternative payment amount under the Medicare program for certain graduate medical education programs established to train residents displaced by natural disasters.

1.

Alternative payment amounts for graduate medical education programs established to train residents displaced by natural disasters

(a)

In general

Notwithstanding any other provision of law, in applying section 1886(h) of the Social Security Act (42 U.S.C. 1395ww(h)), and any regulations implementing such section, with respect to an eligible hospital for a cost reporting period beginning on or after July 1, 2005, the Secretary of Health and Human Services shall provide for payments for direct graduate education costs in accordance with subsection (c) for such hospital and cost reporting period. (b)

Eligible hospital defined

In this section, the term eligible hospital means a hospital that— (1)did not have an approved medical residency training program as defined under section 1886(h)(5)(A) of the Social Security Act (42 U.S.C. 1395ww(h)(5)(A)) before the date of a presidential declaration of major disaster issued under section 401 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act; (2)first participated in such a program to educate residents displaced from a graduate medical education program impacted by such disaster; and (3)is located in a wage area, as defined by the Secretary, that is in, or immediately adjacent to, an area for which such disaster was declared. (c)

Payment to eligible hospitals

The payment amount for an eligible hospital for a cost reporting period in which the hospital operates a graduate medical education program referred to in subsection (b)(2) shall be— (1)for the first such cost reporting period, the reasonable costs (as determined based on rules applied in determining reasonable costs under section 1886(h)(2)(A) of the Social Security Act (42 U.S.C. 1395ww(h)(2)(A))) incurred by the hospital for such program; (2)for the second such cost reporting period, computed based on an alternative FTE resident amount calculated as described in section 1886(h)(2)(A) of the Social Security Act (42 U.S.C. 1395ww(h)(2)(A)), but using the reasonable costs incurred by the hospital for such program during such second cost reporting period and the number of FTE residents (as described in paragraphs (3)(B)(ii) and (4)(E) of section 1886(h) of the Social Security Act (42 U.S.C. 1395ww(h))) in the program for such second cost reporting period; and (3)for the third such cost reporting period and each subsequent cost reporting period, computed based on the alternative FTE resident amount under this section for the previous cost reporting period, updated and adjusted as described in section 1886(h)(2)(D) of the Social Security Act (42 U.S.C. 1395ww(h)(2)(D)).