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        <dc:title>Children’s Hospital GME Support Reauthorization Act of 2013</dc:title>
        <citableAs>Public Law 113–98</citableAs>
        <citableAsShortTitle>Children’s Hospital GME Support Reauthorization Act of 2013</citableAsShortTitle>
        <docNumber>98</docNumber>
        <currentThroughPublicLaw>113–98</currentThroughPublicLaw>
        <dc:type>Statute Compilation</dc:type>
        <dc:creator>United States House of Representatives</dc:creator>
        <dc:creator>Office of the Legislative Counsel</dc:creator>
        <dc:format>text/xml</dc:format>
        <dc:language>EN</dc:language>
        <dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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        <processedDate>2021-10-15</processedDate>
        <containsShortTitle>Children’s Hospital GME Support Reauthorization Act of 2013</containsShortTitle>
        <property role="fileId">10894</property>
        <congress>113</congress>
        <approvedDate>2014-04-07</approvedDate>
    </meta>
    <preface style="-uslm-dtd:compilation-act-form">
        <property style="-uslm-dtd:comp-short-title" role="compShortTitle">Children’s Hospital GME Support Reauthorization Act of 2013</property>
        <citationNote style="-uslm-dtd:public-law">[(<citableAs>Public Law 113–98</citableAs>)]</citationNote>
        <editionNote style="-uslm-dtd:updated-through-note">[This law has not been amended]</editionNote>
        <explanationNote style="-uslm-dtd:explanatory-note"><b>[</b>Currency: This publication is a compilation of the text of Public Law 113-98. It was last amended by the public law listed in the As Amended Through note above and below at the bottom of each page of the pdf version and reflects current law through the date of the enactment of the public law listed at https://www.govinfo.gov/app/collection/comps/<b>]</b></explanationNote>
        <explanationNote style="-uslm-dtd:explanatory-note"><b>[</b>Note: While this publication does  not represent an official version of any Federal statute, substantial efforts have been made to ensure the accuracy of its contents. The official version of Federal law is found in the United States Statutes at Large and in the United States Code. The legal effect to be given to the Statutes at Large and the United States Code is established by statute (1 U.S.C. 112, 204).<b>]</b></explanationNote>
    </preface>
    <main style="-uslm-dtd:legis-body"><longTitle><docTitle style="-uslm-dtd:legis-type">AN ACT</docTitle><officialTitle style="-uslm-dtd:official-title">To amend the Public Health Service Act to reauthorize support for graduate medical education programs in children’s hospitals.</officialTitle></longTitle><enactingFormula style="-uslm-dtd:enacting-clause">Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,</enactingFormula>
        <section style="-uslm-dtd:section" identifier="/us/sComp/113/98/s1" styleType="OLC">
            <num style="-uslm-dtd:enum" value="1">SECTION 1. </num><editorialNote style="-uslm-dtd:usc-reference" role="uscRef"><b>[</b><ref href="/us/usc/t42/s201">42 U.S.C. 201</ref><b>]</b> </editorialNote><heading style="-uslm-dtd:header">SHORT TITLE. </heading>
            <content style="-uslm-dtd:text" class="block">This Act may be cited as the “<shortTitle style="-uslm-dtd:quote"><inline style="-uslm-dtd:short-title">Children’s Hospital GME Support Reauthorization Act of 2013</inline></shortTitle>”.</content>
        </section>
        <section style="-uslm-dtd:section" identifier="/us/sComp/113/98/s2" styleType="OLC">
            <num style="-uslm-dtd:enum" value="2">SEC. 2. </num><heading style="-uslm-dtd:header">PROGRAM OF PAYMENTS TO CHILDREN’S HOSPITALS THAT OPERATE GRADUATE MEDICAL EDUCATION PROGRAMS. </heading>
            <subsection style="-uslm-dtd:subsection" identifier="/us/sComp/113/98/s2/a" styleType="OLC">
                <num style="-uslm-dtd:enum" value="a">(a) </num><heading style="-uslm-dtd:header">In General.—</heading><chapeau style="-uslm-dtd:text">Section 340E of the Public Health Service Act (<ref style="-uslm-dtd:external-xref" href="/us/usc/t42/s256e">42 U.S.C. 256e</ref>) is amended—</chapeau>
                <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/113/98/s2/a/1" styleType="OLC">
                    <num style="-uslm-dtd:enum" value="1">(1) </num><content style="-uslm-dtd:text">in subsection (a), by striking “<quotedText style="-uslm-dtd:quote">through 2005 and each of fiscal years 2007 through 2011</quotedText>” and inserting “<quotedText style="-uslm-dtd:quote">through 2005, each of fiscal years 2007 through 2011, and each of fiscal years 2014 through 2018</quotedText>”; and</content>
                </paragraph>
                <paragraph style="-uslm-dtd:paragraph" identifier="/us/sComp/113/98/s2/a/2" styleType="OLC">
                    <num style="-uslm-dtd:enum" value="2">(2) </num><chapeau style="-uslm-dtd:text">in subsection (f)—</chapeau>
                    <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/113/98/s2/a/2/A" styleType="OLC">
                        <num style="-uslm-dtd:enum" value="A">(A) </num><chapeau style="-uslm-dtd:text">in paragraph (1)(A)—</chapeau>
                        <clause style="-uslm-dtd:clause" identifier="/us/sComp/113/98/s2/a/2/A/i" styleType="OLC">
                            <num style="-uslm-dtd:enum" value="i">(i) </num><content style="-uslm-dtd:text">in clause (iii), by striking “<quotedText style="-uslm-dtd:quote">and</quotedText>”;</content>
                        </clause>
                        <clause style="-uslm-dtd:clause" identifier="/us/sComp/113/98/s2/a/2/A/ii" styleType="OLC">
                            <num style="-uslm-dtd:enum" value="ii">(ii) </num><content style="-uslm-dtd:text">in clause (iv), by striking the period and inserting “<quotedText style="-uslm-dtd:quote">; and</quotedText>”; and</content>
                        </clause>
                        <clause style="-uslm-dtd:clause" identifier="/us/sComp/113/98/s2/a/2/A/iii" styleType="OLC">
                            <num style="-uslm-dtd:enum" value="iii">(iii) </num><content style="-uslm-dtd:text">by adding at the end the following:<quotedContent style="-uslm-dtd:quoted-block">
                            <clause style="-uslm-dtd:clause" styleType="OLC">
                                <num style="-uslm-dtd:enum" value="v">“(v) </num><content style="-uslm-dtd:text">for each of fiscal years 2014 through 2018, $100,000,000.”</content>
                            </clause></quotedContent>; and</content>
                        </clause>
                    </subparagraph>
                    <subparagraph style="-uslm-dtd:subparagraph" identifier="/us/sComp/113/98/s2/a/2/B" styleType="OLC">
                        <num style="-uslm-dtd:enum" value="B">(B) </num><chapeau style="-uslm-dtd:text">in paragraph (2)—</chapeau>
                        <clause style="-uslm-dtd:clause" identifier="/us/sComp/113/98/s2/a/2/B/i" styleType="OLC">
                            <num style="-uslm-dtd:enum" value="i">(i) </num><content style="-uslm-dtd:text">in subparagraph (C), by striking “<quotedText style="-uslm-dtd:quote">and</quotedText>”;</content>
                        </clause>
                        <clause style="-uslm-dtd:clause" identifier="/us/sComp/113/98/s2/a/2/B/ii" styleType="OLC">
                            <num style="-uslm-dtd:enum" value="ii">(ii) </num><content style="-uslm-dtd:text">in subparagraph (D), by striking the period and inserting “<quotedText style="-uslm-dtd:quote">; and</quotedText>”; and</content>
                        </clause>
                        <clause style="-uslm-dtd:clause" identifier="/us/sComp/113/98/s2/a/2/B/iii" styleType="OLC">
                            <num style="-uslm-dtd:enum" value="iii">(iii) </num><content style="-uslm-dtd:text">by adding at the end the following:<quotedContent style="-uslm-dtd:quoted-block">
                            <subparagraph style="-uslm-dtd:subparagraph" styleType="OLC">
                                <num style="-uslm-dtd:enum" value="E">“(E) </num><content style="-uslm-dtd:text">for each of fiscal years 2014 through 2018, $200,000,000.”</content>
                            </subparagraph></quotedContent>.</content>
                        </clause>
                    </subparagraph>
                </paragraph>
            </subsection>
            <subsection style="-uslm-dtd:subsection" identifier="/us/sComp/113/98/s2/b" styleType="OLC">
                <num style="-uslm-dtd:enum" value="b">(b) </num><heading style="-uslm-dtd:header">Report to Congress.—</heading><content style="-uslm-dtd:text">Section 340E(b)(3)(D) of the Public Health Service Act (<ref style="-uslm-dtd:external-xref" href="/us/usc/t42/s256e/b/3/D">42 U.S.C. 256e(b)(3)(D)</ref>) is amended by striking “<quotedText style="-uslm-dtd:quote">Not later than the end of fiscal year 2011</quotedText>” and inserting “<quotedText style="-uslm-dtd:quote">Not later than the end of fiscal year 2018</quotedText>”.</content>
            </subsection>
        </section>
        <section style="-uslm-dtd:section" identifier="/us/sComp/113/98/s3" styleType="OLC">
            <num style="-uslm-dtd:enum" value="3">SEC. 3. </num><heading style="-uslm-dtd:header">SUPPORT OF GRADUATE MEDICAL EDUCATION PROGRAMS IN CERTAIN HOSPITALS. </heading>
            <content style="-uslm-dtd:text" class="block">Section 340E of the Public Health Service Act (<ref style="-uslm-dtd:external-xref" href="/us/usc/t42/s256e">42 U.S.C. 256e</ref>) is amended by adding at the end the following:<quotedContent style="-uslm-dtd:quoted-block">
            <subsection style="-uslm-dtd:subsection" styleType="OLC">
                <num style="-uslm-dtd:enum" value="h">“(h) </num><heading style="-uslm-dtd:header">Additional Provisions. </heading>
                <paragraph style="-uslm-dtd:paragraph" styleType="OLC">
                    <num style="-uslm-dtd:enum" value="1">“(1) </num><heading style="-uslm-dtd:header">In general. </heading><content style="-uslm-dtd:text">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).</content>
                </paragraph>
                <paragraph style="-uslm-dtd:paragraph" styleType="OLC">
                    <num style="-uslm-dtd:enum" value="2">“(2) </num><heading style="-uslm-dtd:header">Qualified hospitals. </heading>
                    <subparagraph style="-uslm-dtd:subparagraph" styleType="OLC">
                        <num style="-uslm-dtd:enum" value="A">“(A) </num><heading style="-uslm-dtd:header">In general. </heading><chapeau style="-uslm-dtd:text">To qualify to receive payments under paragraph (1), a hospital shall be a free-standing hospital—</chapeau>
                        <clause style="-uslm-dtd:clause" styleType="OLC">
                            <num style="-uslm-dtd:enum" value="i">“(i) </num><content style="-uslm-dtd:text">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;</content>
                        </clause>
                        <clause style="-uslm-dtd:clause" styleType="OLC">
                            <num style="-uslm-dtd:enum" value="ii">“(ii) </num><content style="-uslm-dtd:text">whose inpatients are predominantly individuals under 18 years of age;</content>
                        </clause>
                        <clause style="-uslm-dtd:clause" styleType="OLC">
                            <num style="-uslm-dtd:enum" value="iii">“(iii) </num><content style="-uslm-dtd:text">that has an approved medical residency training program as defined in section 1886(h)(5)(A) of the Social Security Act; and</content>
                        </clause>
                        <clause style="-uslm-dtd:clause" styleType="OLC">
                            <num style="-uslm-dtd:enum" value="iv">“(iv) </num><content style="-uslm-dtd:text">that is not otherwise qualified to receive payments under this section or section 1886(h) of the Social Security Act.</content>
                        </clause>
                    </subparagraph>
                    <subparagraph style="-uslm-dtd:subparagraph" styleType="OLC">
                        <num style="-uslm-dtd:enum" value="B">“(B) </num><heading style="-uslm-dtd:header">Establishment of residency cap. </heading><content style="-uslm-dtd:text">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.</content>
                    </subparagraph>
                </paragraph>
                <paragraph style="-uslm-dtd:paragraph" styleType="OLC">
                    <num style="-uslm-dtd:enum" value="3">“(3) </num><heading style="-uslm-dtd:header">Payments. </heading><content style="-uslm-dtd:text">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).</content>
                </paragraph>
                <paragraph style="-uslm-dtd:paragraph" styleType="OLC">
                    <num style="-uslm-dtd:enum" value="4">“(4) </num><heading style="-uslm-dtd:header">Payment amounts. </heading><content style="-uslm-dtd:text">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).</content>
                </paragraph>
                <paragraph style="-uslm-dtd:paragraph" styleType="OLC">
                    <num style="-uslm-dtd:enum" value="5">“(5) </num><heading style="-uslm-dtd:header">Reporting. </heading><content style="-uslm-dtd:text">A hospital receiving payments under this subsection shall be subject to the reporting requirements under subsection (b)(3).</content>
                </paragraph>
                <paragraph style="-uslm-dtd:paragraph" styleType="OLC">
                    <num style="-uslm-dtd:enum" value="6">“(6) </num><heading style="-uslm-dtd:header">Remaining funds. </heading>
                    <subparagraph style="-uslm-dtd:subparagraph" styleType="OLC">
                        <num style="-uslm-dtd:enum" value="A">“(A) </num><heading style="-uslm-dtd:header">In general. </heading><content style="-uslm-dtd:text">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).</content>
                    </subparagraph>
                    <subparagraph style="-uslm-dtd:subparagraph" styleType="OLC">
                        <num style="-uslm-dtd:enum" value="B">“(B) </num><heading style="-uslm-dtd:header">Quality bonus system. </heading><content style="-uslm-dtd:text">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.”</content>
                    </subparagraph>
                </paragraph>
            </subsection></quotedContent>.</content>
        </section>
    </main>
</statuteCompilation>
