[Congressional Record Volume 152, Number 99 (Tuesday, July 25, 2006)]
[Senate]
[Pages S8201-S8202]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. KOHL:
  S. 3727. A bill to amend title XVIII of the Social Security Act to 
provide for an adjustment to the reduction of Medicare resident 
positions based on settled cost reports; to the Committee on Finance.
  Mr. KOHL. Mr. President, today I am introducing the Medicare 
Residency Program Fairness Act of 2006. This bill would provide for an 
adjustment to the reduction of Medicare resident positions based on 
settled cost reports. The reason I am introducing this bill is because 
unintended consequences of Section 422 of the Medicare Modernization 
Act of 2003 have resulted in a decrease of residents slots in 
Wisconsin's Fox Valley and potentially in other small urban and rural 
family medicine practices across the Nation.
  For more than a year, I have been working with the University of 
Wisconsin School of Medicine and the Fox Valley Fami1y Medicine 
Residency Program to urge CMS to restore funding for its residency 
training positions that was taken away as a result of an audit that 
incorrectly determined that the positions were not used. Now, a Final 
Mediation Agreement between Appleton Medical Center and United 
Government Services demonstrates that the positions were being used and 
that the program met the Medicare requirement for those positions. I 
believe it is only fair that Appleton Medical Center's residency 
positions be reinstated.
  The Fox Valley Family Practice Residency Program is an important 
contributing member to the Fox Valley and surrounding community, 
providing health care services to some 10,000 families. This is exactly 
the type of program that we should be supporting, not reducing. My 
legislation will right this wrong and provide for the same opportunity 
for any other small urban or rural program that can demonstrate that 
its residency slots were erroneously de-funded by CMS. I ask that my 
Senate colleagues join me by supporting this bill. I ask unanimous 
consent that the text of the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 3727

       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 Residency Program 
     Fairness Act of 2006''.

     SEC. 2. ADJUSTMENT TO THE REDUCTION OF MEDICARE RESIDENT 
                   POSITIONS BASED ON SETTLED COST REPORTS.

       (a) In General.--Section 1886(h)(7) of the Social Security 
     Act (42 U.S.C. 1395ww(h)(7)) is amended--
       (1) by redesignating subparagraph (D) as subparagraph (E); 
     and
       (2) by adding at the end the following new subparagraph:

[[Page S8202]]

       ``(D) Adjustment based on settled cost report for rural and 
     small urban hospitals.--In the case of a hospital located in 
     a rural area (as defined in subsection (d)(2)(D)) or in an 
     urban area that is not a large urban area (as so defined) for 
     which--
       ``(i) the otherwise applicable resident limit was reduced 
     under subparagraph (A)(i)(I); and
       ``(ii) such reduction was based on a reference resident 
     level that was determined using a cost report that was 
     subsequently settled, whether as a result of an appeal or 
     otherwise, and the reference resident level under such 
     settled cost report is higher than the level used for the 
     reduction under subparagraph (A)(i)(I);

     the Secretary shall apply subparagraph (A)(i)(I) using the 
     higher resident reference level and make any necessary 
     adjustments to the reduction described in subclause (II). Any 
     such necessary adjustments shall be effective for portions of 
     cost reporting periods occurring on or after July 1, 2005.''.
       (b) Effective Date.--The amendments made by this section 
     shall take effect as if included in the enactment of section 
     422 of the Medicare Prescription Drug, Improvement, and 
     Modernization Act of 2003 (Public Law 108-173).
                                 ______