[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 2116 Introduced in Senate (IS)]
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116th CONGRESS
1st Session
S. 2116
To amend title XVIII of the Social Security Act to establish rules for
payment for graduate medical education (GME) costs for hospitals that
establish a new medical residency training program after hosting
resident rotators for short durations.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 15, 2019
Mr. Menendez (for himself and Mr. Booker) 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 establish rules for
payment for graduate medical education (GME) costs for hospitals that
establish a new medical residency training program after hosting
resident rotators for short durations.
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 ``Supporting Graduate Medical
Education at Community Hospitals Act of 2019''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Graduate Medical Education or ``GME'' training programs
are of critical importance in developing the physician
workforce.
(2) Current caps on GME training programs under Medicare
have been in place since 1997.
(3) Hospitals seeking to launch GME training programs face
barriers in establishing physician training programs in
community hospitals.
SEC. 3. MEDICARE GME TREATMENT OF HOSPITALS ESTABLISHING NEW MEDICAL
RESIDENCY TRAINING PROGRAMS AFTER HOSTING MEDICAL
RESIDENT ROTATORS FOR SHORT DURATIONS.
(a) Redetermination of Approved FTE Resident Amount.--Section
1886(h)(2)(F) of the Social Security Act (42 U.S.C. 1395ww(h)(2)(F)) is
amended--
(1) by inserting ``(i)'' before ``In the case of''; and
(2) by adding at the end the following:
``(ii) In applying this subparagraph to a hospital
that has not entered into a GME affiliation agreement
(as defined by the Secretary for purposes of paragraph
(4)(H)(ii)), the Secretary shall not provide for the
establishment of an FTE resident amount until such time
as the Secretary determines that the hospital has a
medical residency training program that trains more
than 1.0 full-time-equivalent resident in a cost
reporting period.
``(iii) In the case of a hospital with an approved
FTE resident amount--
``(I) based on the training of less than
1.0 full-time-equivalent resident before
October 1, 1997;
``(II) based on the training of--
``(aa) no more than 6.0 full-time-
equivalent residents in a medical
residency training program in any cost
reporting period during the period
between October 1, 1996, and September
30, 1997; and
``(bb) no more than 3.0 full-time-
equivalent residents on or after
October 1, 1997; or
``(III) based on the training of no full-
time-equivalent residents in a medical
residency training program for any 20
consecutive cost reporting periods beginning on
or after October 1, 1997,
the Secretary shall provide the hospital an opportunity
to have a new FTE resident amount established when the
hospital begins training at least 1.0 full-time
equivalent resident (in the case of a hospital
described in subclauses (I or III)) or more than 3.0
full-time-equivalent residents (in the case of a
hospital described in subclause (II)) for cost
reporting periods beginning on or after the date of the
enactment of this clause and in accordance with the
methodology under the rules in effect as of October 1,
2015.''.
(b) Redetermination of FTE Resident Limitation.--Section
1886(h)(4)(H)(i) of the Social Security Act (42 U.S.C.
1395ww(h)(4)(H)(i)) is amended--
(1) by inserting ``(I)'' before ``The Secretary''; and
(2) by adding at the end the following:
``(II) Under this clause the Secretary
shall not determine an adjustment in the
limitation applicable to a hospital under
subparagraph (F) until the hospital trains more
than 1.0 full-time equivalent resident in a new
medical residency training program in a cost
reporting period.
``(III) In the case of a hospital that has
a limitation under subparagraph (F) of less
than 1.0 full-time-equivalent resident as of
the date of the enactment of this subclause
based on training before October 1, 1997, under
this clause the Secretary shall provide the
hospital an opportunity to have a new
adjustment in such limitation determined when
such hospital begins training at least 1.0
full-time equivalent resident in accordance
with the methodology applicable to hospitals
under the rules in effect as of October 1,
2015, and applied for cost reporting periods
beginning on or after the date of the enactment
of this subclause.
``(IV) In the case of a hospital that has
not reported full-time-equivalent residents in
20 consecutive cost reporting periods
subsequent to October 1, 1997, under this
clause the Secretary shall provide the hospital
an opportunity to have a new adjustment in such
limitation determined when such hospital begins
training at least 1.0 full-time equivalent
resident in accordance with the methodology
applicable to hospitals under the rules in
effect as of October 1, 2015, and applied for
cost reporting periods beginning on or after
the date of the enactment of this subclause.
``(V) In the case of a hospital for which
an adjustment in the limitation applicable to a
hospital under subparagraph (F) is based on the
training of no more than 3.0 full-time-
equivalent residents in a medical residency
training program in a cost reporting period
beginning on or after October 1, 1997, and
before the date of the enactment of this
subclause, the Secretary shall provide the
hospital an opportunity to have a new
adjustment in such limitation determined when
the hospital begins training more than 3.0
full-time-equivalent residents in accordance
with the methodology applicable to hospitals
under the rules in effect as of October 1,
2015, and applied for cost reporting periods
beginning on or after the date of the enactment
of this subclause.''.
(c) Effective Date.--The amendments made by this section shall
apply to payment under section 1886 of the Social Security Act (42
U.S.C. 1395ww) for cost reporting periods beginning on or after the
date of the enactment of this Act.
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