[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 1557 Introduced in Senate (IS)]

113th CONGRESS
  1st Session
                                S. 1557

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


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 27, 2013

Mr. Casey (for himself, Mr. Isakson, Mr. Whitehouse, Mr. Alexander, Mr. 
 Brown, Mr. Kirk, Mr. Harkin, Mr. Blunt, Ms. Warren, Mr. Roberts, Mr. 
 Blumenthal, Mr. Murphy, and Mr. Reed) introduced the following bill; 
     which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
   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 2013''.

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 striking ``through 2005 and each 
        of fiscal years 2007 through 2011'' and inserting ``through 
        2005, each of fiscal years 2007 through 2011, and each of 
        fiscal years 2014 through 2018''; and
            (2) in subsection (f)--
                    (A) in paragraph (1)(A)--
                            (i) in clause (iii), by striking ``and'';
                            (ii) in clause (iv), by striking the period 
                        and inserting ``; and''; and
                            (iii) by adding at the end the following:
                            ``(v) for each of fiscal years 2014 through 
                        2018, $100,000,000.''; and
                    (B) in paragraph (2)--
                            (i) in subparagraph (C), by striking 
                        ``and'';
                            (ii) in subparagraph (D), by striking the 
                        period and inserting ``; and''; and
                            (iii) by adding at the end the following:
                    ``(E) for each of fiscal years 2014 through 2018, 
                $200,000,000.''.
    (b) Report to Congress.--Section 340E(b)(3)(D) of the Public Health 
Service Act (42 U.S.C. 256e(b)(3)(D)) is amended by striking ``Not 
later than the end of fiscal year 2011'' and inserting ``Not later than 
the end of fiscal year 2018''.

SEC. 3. SUPPORT OF GRADUATE MEDICAL EDUCATION PROGRAMS IN CERTAIN 
              HOSPITALS.

    Section 340E of the Public Health Service Act (42 U.S.C. 256e) is 
amended by adding at the end the following:
    ``(h) Additional Provisions.--
            ``(1) In general.--The Secretary is authorized to make 
        available up to 25 percent of the total amounts in excess of 
        $245,000,000 appropriated under paragraphs (1) and (2) of 
        subsection (f), but not to exceed $7,000,000, for payments to 
        hospitals qualified as described in paragraph (2), for the 
        direct and indirect expenses associated with operating approved 
        graduate medical residency training programs, as described in 
        subsection (a).
            ``(2) Qualified hospitals.--
                    ``(A) In general.--To qualify to receive payments 
                under paragraph (1), a hospital shall be a free-
                standing hospital--
                            ``(i) with a Medicare payment agreement and 
                        that is excluded from the Medicare inpatient 
                        hospital prospective payment system pursuant to 
                        section 1886(d)(1)(B) of the Social Security 
                        Act and its accompanying regulations;
                            ``(ii) whose inpatients are predominantly 
                        individuals under 18 years of age;
                            ``(iii) that has an approved medical 
                        residency training program as defined in 
                        section 1886(h)(5)(A) of the Social Security 
                        Act; and
                            ``(iv) that is not otherwise qualified to 
                        receive payments under this section or section 
                        1886(h) of the Social Security Act.
                    ``(B) Establishment of residency cap.--In the case 
                of a freestanding children's hospital that, on the date 
                of enactment of this subsection, meets the requirements 
                of subparagraph (A) but for which the Secretary has not 
                determined an average number of full-time equivalent 
                residents under section 1886(h)(4) of the Social 
                Security Act, the Secretary may establish such number 
                of full-time equivalent residents for the purposes of 
                calculating payments under this subsection.
            ``(3) Payments.--Payments to hospitals made under this 
        subsection shall be made in the same manner as payments are 
        made to children's hospitals, as described in subsections (b) 
        through (e).
            ``(4) Payment amounts.--The direct and indirect payment 
        amounts under this subsection shall be determined using per 
        resident amounts that are no greater than the per resident 
        amounts used for determining direct and indirect payment 
        amounts under subsection (a).
            ``(5) Reporting.--A hospital receiving payments under this 
        subsection shall be subject to the reporting requirements under 
        subsection (b)(3).
            ``(6) Remaining funds.--
                    ``(A) In general.--If the payments to qualified 
                hospitals under paragraph (1) for a fiscal year are 
                less than the total amount made available under such 
                paragraph for that fiscal year, any remaining amounts 
                for such fiscal year may be made available to all 
                hospitals participating in the program under this 
                subsection or subsection (a).
                    ``(B) Quality bonus system.--For purposes of 
                distributing the remaining amounts described in 
                subparagraph (A), the Secretary may establish a quality 
                bonus system, whereby the Secretary distributes bonus 
                payments to hospitals participating in the program 
                under this subsection or subsection (a) that meet 
                standards specified by the Secretary, which may include 
                a focus on quality measurement and improvement, 
                interpersonal and communications skills, delivering 
                patient-centered care, and practicing in integrated 
                health systems, including training in community-based 
                settings. In developing such standards, the Secretary 
                shall collaborate with relevant stakeholders, including 
                program accrediting bodies, certifying boards, training 
                programs, health care organizations, health care 
                purchasers, and patient and consumer groups.''.
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