[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3292 Introduced in House (IH)]

114th CONGRESS
  1st Session
                                H. R. 3292

  To amend title XVIII of the Social Security Act to revise Medicare 
    payment for indirect medical education (IME) costs in teaching 
                               hospitals.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 29, 2015

Mr. Brady of Texas introduced the following bill; which was referred to 
                    the Committee on Ways and Means

_______________________________________________________________________

                                 A BILL


 
  To amend title XVIII of the Social Security Act to revise Medicare 
    payment for indirect medical education (IME) costs in teaching 
                               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 ``Medicare IME Pool Act of 2015''.

SEC. 2. REVISION OF MEDICARE PAYMENTS FOR INDIRECT MEDICAL EDUCATION 
              (IME) COSTS IN TEACHING HOSPITALS.

    (a) In General.--Section 1886 of the Social Security Act (42 U.S.C. 
1395ww) is amended--
            (1) in subsection (d)(5)(B)--
                    (A) in the clause (x) added by section 5505(b) of 
                the Patient Protection and Affordable Care Act--
                            (i) by moving the indentation of each 
                        provision in such clause 6 ems to the left; and
                            (ii) by redesignating such clause as clause 
                        (xi); and
                    (B) by adding at the end the following new clause:
    ``(xii) With respect to discharges occurring in cost reporting 
periods ending during or after fiscal year 2019, instead of the 
additional payment that would have been paid under this subparagraph to 
a subsection (d) hospital or a subsection (d) Puerto Rico hospital with 
indirect costs of medical education and notwithstanding the previous 
provisions of this subparagraph, there shall be paid to the hospital 
the payment determined under subsection (t) for such hospital and cost 
reporting period.''; and
            (2) by adding at the end the following new subsection:
    ``(t) Payment for Indirect Medical Education.--
            ``(1) In general.--
                    ``(A) Amount of payment.--For purposes of 
                subsection (d)(5)(B)(xii), the payment under this 
                subsection for a subsection (d) hospital (or a 
                subsection (d) Puerto Rico hospital) for a cost 
                reporting period ending during or after fiscal year 
                2019 is the payment of an amount equal to the product 
                of--
                            ``(i) the IME pool amount computed under 
                        paragraph (2) for the fiscal year; and
                            ``(ii) the allotment factor under paragraph 
                        (3) for such cost reporting period and fiscal 
                        year.
                    ``(B) Form of payment.--Payments of amounts under 
                this subsection shall be made from the Federal Hospital 
                Insurance Trust Fund with respect to a cost reporting 
                period in accordance with such timing as the Secretary 
                determines is similar to the timing of additional 
                payments that are made under subsection (h).
            ``(2) IME pool amount.--
                    ``(A) In general.--The IME pool amount under this 
                paragraph--
                            ``(i) for fiscal year 2019 is equal to the 
                        base amount computed under subparagraph (B); 
                        and
                            ``(ii) for a subsequent fiscal year is 
                        equal to the sum of--
                                    ``(I) the IME pool amount under 
                                this paragraph for the previous fiscal 
                                year increased by the market basket 
                                percentage increase (as defined in 
                                subsection (b)(3)(B)(iii)) applicable 
                                to discharges occurring in such 
                                subsequent fiscal year; and
                                    ``(II) the new teaching program 
                                amount computed under subparagraph (C) 
                                for the fiscal year.
                    ``(B) Base amount.--The base amount computed under 
                this subparagraph is $9,500,000,000, increased by the 
                sum, for each of fiscal years 2015 through 2019, of the 
                product of--
                            ``(i) the weighted average number of full-
                        time-equivalent resident positions in approved 
                        medical residency training programs (as 
                        determined under subsection (h)(4)) for which 
                        payment is first made under subsection (h) in 
                        the fiscal year; and
                            ``(ii) the Secretary's estimate of the 
                        national average expenditures per resident 
                        position that are attributable to additional 
                        payments under subsection (d)(5)(B) for 
                        discharges in such fiscal year.
                    ``(C) Adjustment for new teaching programs.--The 
                new teaching program amount computed under this 
                subparagraph for a fiscal year is equal to the product 
                of--
                            ``(i) the weighted average number of full-
                        time-equivalent resident positions in approved 
                        medical residency training programs (as 
                        determined under subsection (h)(4)) for which 
                        payment is first made under subsection (h) in 
                        the fiscal year; and
                            ``(ii) the IME pool amount under this 
                        paragraph for the fiscal year (determined 
                        without regard to this subparagraph), divided 
                        by the average number of all full-time-
                        equivalent resident positions in approved 
                        medical residency training programs (as 
                        determined under subsection (h)(4)) for which 
                        payment is made under subsection (h) in the 
                        fiscal year (as estimated by the Secretary).
            ``(3) Allotment based on fte resident count.--The allotment 
        factor under this paragraph for a hospital eligible to receive 
        payment under this subsection with respect to a cost reporting 
        period ending in a fiscal year is equal to the ratio (as 
        estimated by the Secretary) of--
                    ``(A) the weighted average number of full-time-
                equivalent residents for the hospital for the cost 
                reporting period (as determined under subsection 
                (h)(4)); to
                    ``(B) the total of the weighted average numbers of 
                full-time-equivalent residents, as determined under 
                subparagraph (A), for all such hospitals for cost 
                reporting periods ending in such fiscal year.
        The Secretary shall make such adjustments in such allotment 
        factor for subsequent cost reporting periods as the Secretary 
        determines necessary to account for errors in the Secretary's 
        estimation of such allotment factor under this paragraph for 
        previous cost reporting periods.''.
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