[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 1754 Introduced in Senate (IS)]

<DOC>






115th CONGRESS
  1st Session
                                S. 1754

    To reauthorize section 340H of the Public Health Service Act to 
continue to encourage the expansion, maintenance, and establishment of 
  approved graduate medical residency programs at qualified teaching 
                health centers, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             August 3, 2017

  Ms. Collins (for herself, Mr. Tester, Mr. Cochran, Mr. Manchin, Mr. 
  Daines, Ms. Harris, and Mr. Boozman) introduced the following bill; 
     which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
    To reauthorize section 340H of the Public Health Service Act to 
continue to encourage the expansion, maintenance, and establishment of 
  approved graduate medical residency programs at qualified teaching 
                health centers, and for other purposes.

    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 ``Training the Next Generation of 
Primary Care Doctors Act of 2017''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) The program of payments to teaching health centers for 
        graduate medical education under section 340H of the Public 
        Health Service Act (42 U.S.C. 256h) was enacted in 2010 to 
        address the crisis-level shortage of primary care physicians, 
        especially in rural and medically underserved communities.
            (2) Teaching health center residents and faculty will 
        provide more than one million primary care medical visits in 
        2017 to underserved communities.
            (3) When compared with traditional Medicare GME residents, 
        residents who train at teaching health centers are more likely 
        to practice primary care and remain in underserved or rural 
        communities.
            (4) The teaching health center program not only plays a 
        vital role in training the Nation's next generation of primary 
        care physicians (including dentists), but helps bridge the 
        Nation's physician shortfall.
            (5) For these reasons, it is of vital importance to 
        continue the program under section 340H of the Public Health 
        Service Act (42 U.S.C. 256h) at a sustainable level of funding 
        per full-time equivalent resident, as recommended in the fact 
        sheet of the Health Resources and Services Administration 
        entitled ``Cost Estimates for Training Residents in a Teaching 
        Health Center''.

SEC. 3. REAUTHORIZATION OF PROGRAM OF PAYMENTS TO TEACHING HEALTH 
              CENTERS THAT OPERATE GRADUATE MEDICAL EDUCATION PROGRAMS.

    (a) Payments.--Subsection (a) of section 340H of the Public Health 
Service Act (42 U.S.C. 256h) is amended to read as follows:
    ``(a) Payments.--
            ``(1) In general.--Subject to subsection (h)(2), the 
        Secretary shall make payments under this section for direct 
        expenses and indirect expenses to qualified teaching health 
        centers that are listed as sponsoring institutions by the 
        relevant accrediting body for--
                    ``(A) maintenance of existing approved graduate 
                medical residency training programs;
                    ``(B) expansion of existing approved graduate 
                medical residency training programs; and
                    ``(C) establishment of new approved graduate 
                medical residency training programs.
            ``(2) New programs.--
                    ``(A) Payments.--The Secretary shall make payments 
                under paragraph (1)(C)--
                            ``(i) for fiscal year 2019, for a total of 
                        up to 60 full-time equivalent residents at new 
                        approved graduate medical residency programs; 
                        and
                            ``(ii) for fiscal year 2020, for a total of 
                        up to 120 full-time equivalent residents at new 
                        approved graduate medical residency programs.
                    ``(B) Priority.--Subject to subparagraph (C), in 
                making payments pursuant to paragraph (1)(C), the 
                Secretary shall give priority to qualified teaching 
                health centers that--
                            ``(i) serve a health professional shortage 
                        area with a designation in effect under section 
                        332 or a medically underserved community (as 
                        defined in section 799B); or
                            ``(ii) are located in a rural area (as 
                        defined in section 1886(d)(2)(D) of the Social 
                        Security Act).
                    ``(C) Limitations.--The number of full-time 
                equivalent residents for which a qualified teaching 
                health center receives payments pursuant to paragraph 
                (1)(C) for a fiscal year shall not exceed by more than 
                6 the number of full-time equivalent residents for 
                which the center received such payments for the 
                preceding fiscal year. The total number of full-time 
                equivalent residents at all qualified teaching health 
                centers for which payments are made by the Secretary 
                under subparagraphs (A) and (B) of subsection (a)(1) 
                shall not exceed the total number of full-time 
                equivalent residents at all qualified teaching health 
                centers for which payments were made by the Secretary 
                as of January 1, 2017, pursuant to this section.''.
    (b) Funding.--Subsection (g) of the first section 340H of the 
Public Health Service Act (42 U.S.C. 256h) is amended to read as 
follows:
    ``(g) Funding.--
            ``(1) Existing programs.--Out of any money in the Treasury 
        not otherwise appropriated, there are appropriated for payments 
        under subparagraphs (A) and (B) of subsection (a)(1) 
        $116,500,000 for each of fiscal years 2018, 2019, and 2020, to 
        remain available until expended.
            ``(2) Incentive for new programs.--Out of any money in the 
        Treasury not otherwise appropriated, there are appropriated for 
        payments under subsection (a)(1)(C), $10,000,000 for fiscal 
        year 2019 and $19,000,000 for fiscal year 2020, to remain 
        available until expended.
            ``(3) Administrative expenses.--Of the amount made 
        available to carry out this section for any fiscal year, the 
        Secretary may not use more than 5 percent of such amount for 
        the expenses of administering this section.''.
    (c) Annual Reporting.--Paragraph (1) of subsection (h) of the first 
section 340H of the Public Health Service Act (42 U.S.C. 256h) is 
amended--
            (1) by redesignating subparagraph (D) as subparagraph (H); 
        and
            (2) by inserting after subparagraph (C) the following:
                    ``(D) The number of patients treated by residents 
                described in paragraph (4).
                    ``(E) The number of visits by patients treated by 
                residents described in paragraph (4).
                    ``(F) Of the number of residents described in 
                paragraph (4) who completed their residency training at 
                the end of such residency academic year, the number and 
                percentage of such residents entering primary care 
                practice (meaning any of the areas of practice listed 
                in the definition of a primary care residency program 
                in section 749A).
                    ``(G) Of the number of residents described in 
                paragraph (4) who completed their residency training at 
                the end of such residency academic year, the number and 
                percentage of such residents who entered practice at a 
                health care facility--
                            ``(i) primarily serving a health 
                        professional shortage area with a designation 
                        in effect under section 332 or a medically 
                        underserved community (as defined in section 
                        799B); or
                            ``(ii) located in a rural area (as defined 
                        in section 1886(d)(2)(D) of the Social Security 
                        Act).''.
    (d) Report on Training Costs.--Not later than March 31, 2020, the 
Secretary of Health and Human Services shall submit to the Congress a 
report on the direct graduate expenses of approved graduate medical 
residency training programs, and the indirect expenses associated with 
the additional costs of teaching residents, of qualified teaching 
health centers (as such terms are used or defined in section 340H of 
the Public Health Service Act (42 U.S.C. 256h)).
    (e) Definition.--Subsection (j) of the first section 340H of the 
Public Health Service Act (42 U.S.C. 256h) is amended--
            (1) by redesignating paragraphs (2) and (3) as paragraphs 
        (3) and (4), respectively; and
            (2) by inserting after paragraph (1) the following:
            ``(2) New approved graduate medical residency training 
        program.--The term `new approved graduate medical residency 
        training program' means an approved graduate medical residency 
        training program for which the sponsoring qualified teaching 
        health center has not received a payment under this section for 
        a previous fiscal year (other than pursuant to subsection 
        (a)(1)(C)).''.
    (f) Technical Corrections.--Part D of title III of the Public 
Health Service Act (42 U.S.C. 254b et seq.) is amended--
            (1) in subsection (f) of the first section 340H (42 U.S.C. 
        256h), by striking ``hospital'' each place it appears and 
        inserting ``teaching health center'';
            (2) by redesignating the second subpart XI (relating to a 
        community-based collaborative care network program) as subpart 
        XII; and
            (3) by redesignating the second section 340H (42 U.S.C. 
        256i) as section 340I.
    (g) Payments for Previous Fiscal Years.--The provisions of the 
first section 340H of the Public Health Service Act (42 U.S.C. 256h), 
as in effect on the day before the date of enactment of this Act, shall 
continue to apply with respect to payments under such section for 
fiscal years before fiscal year 2018.
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