[Congressional Record Volume 152, Number 122 (Tuesday, September 26, 2006)]
[Senate]
[Page S10217]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 AMENDING THE PUBLIC HEALTH SERVICE ACT

  Mr. McCONNELL. Mr. President, I ask unanimous consent that the HELP 
Committee be discharged from further consideration of H.R. 5574 and the 
Senate proceed to its immediate consideration.
  The PRESIDING OFFICER. Without objection, it is so ordered. The clerk 
will report the bill by title.
  The assistant legislative clerk read as follows:

       A bill (H.R. 5574) to amend the Public Health Service Act 
     to reauthorize support for graduate medical education 
     programs in children's hospitals.

  There being no objection, the Senate proceeded to consider the bill.
  Mr. McCONNELL. Mr. President, I ask unanimous consent that the 
amendment at the desk be agreed to, the bill, as amended, be read a 
third time and passed, the motion to reconsider be laid upon the table, 
and that any statements relating to the measure be printed in the 
Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The amendment (No. 5073) was agreed to, as follows:
       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Children's Hospital GME 
     Support Reauthorization Act of 2006''.

     SEC. 2. PROGRAM OF PAYMENTS TO CHILDREN'S HOSPITALS THAT 
                   OPERATE GRADUATE MEDICAL EDUCATION PROGRAMS.

       (a) In General.--Section 340E of the Public Health Service 
     Act (42 U.S.C. 256e) is amended--
       (1) in subsection (a), by inserting ``and each of fiscal 
     years 2007 through 2011'' after ``for each of fiscal years 
     2000 through 2005'';
       (2) in subsection (e)(1), by striking ``26'' and inserting 
     ``12'';
       (3) in subsection (f)(1)(A)--
       (A) in clause (ii), by striking ``and'' at the end;
       (B) in clause (iii), by striking the period at the end and 
     inserting ``; and''; and
       (C) by adding at the end the following:
       ``(iv) for each of fiscal years 2007 through 2011, 
     $110,000,000.''; and
       (4) in subsection (f)(2)--
       (A) in the matter before subparagraph (A), by striking 
     ``subsection (b)(1)(A)'' and inserting ``subsection 
     (b)(1)(B)'';
       (B) in subparagraph (B), by striking ``and'' at the end;
       (C) in subparagraph (C), by striking the period at the end 
     and inserting ``; and''; and
       (D) by adding at the end the following:
       ``(D) for each of fiscal years 2007 through 2011, 
     $220,000,000.''.
       (b) Reduction in Payments for Failure to File Annual 
     Report.--Subsection (b) of section 340E of the Public Health 
     Service Act (42 U.S.C. 256e) is amended--
       (1) in paragraph (1), in the matter before subparagraph 
     (A), by striking ``paragraph (2)'' and inserting ``paragraphs 
     (2) and (3)''; and
       (2) by adding at the end the following:
       ``(3) Annual reporting required.--
       ``(A) Reduction in payment for failure to report.--
       ``(i) In general.--The amount payable under this section to 
     a children's hospital for a fiscal year (beginning with 
     fiscal year 2008 and after taking into account paragraph (2)) 
     shall be reduced by 25 percent if the Secretary determines 
     that--

       ``(I) the hospital has failed to provide the Secretary, as 
     an addendum to the hospital's application under this section 
     for such fiscal year, the report required under subparagraph 
     (B) for the previous fiscal year; or
       ``(II) such report fails to provide the information 
     required under any clause of such subparagraph.

       ``(ii) Notice and opportunity to provide missing 
     information.--Before imposing a reduction under clause (i) on 
     the basis of a hospital's failure to provide information 
     described in clause (i)(II), the Secretary shall provide 
     notice to the hospital of such failure and the Secretary's 
     intention to impose such reduction and shall provide the 
     hospital with the opportunity to provide the required 
     information within a period of 30 days beginning on the date 
     of such notice. If the hospital provides such information 
     within such period, no reduction shall be made under clause 
     (i) on the basis of the previous failure to provide such 
     information.
       ``(B) Annual report.--The report required under this 
     subparagraph for a children's hospital for a fiscal year is a 
     report that includes (in a form and manner specified by the 
     Secretary) the following information for the residency 
     academic year completed immediately prior to such fiscal 
     year:
       ``(i) The types of resident training programs that the 
     hospital provided for residents described in subparagraph 
     (C), such as general pediatrics, internal medicine/
     pediatrics, and pediatric subspecialties, including both 
     medical subspecialties certified by the American Board of 
     Pediatrics (such as pediatric gastroenterology) and non-
     medical subspecialties approved by other medical 
     certification boards (such as pediatric surgery).
       ``(ii) The number of training positions for residents 
     described in subparagraph (C), the number of such positions 
     recruited to fill, and the number of such positions filled.
       ``(iii) The types of training that the hospital provided 
     for residents described in subparagraph (C) related to the 
     health care needs of different populations, such as children 
     who are underserved for reasons of family income or 
     geographic location, including rural and urban areas.
       ``(iv) The changes in residency training for residents 
     described in subparagraph (C) which the hospital has made 
     during such residency academic year (except that the first 
     report submitted by the hospital under this subparagraph 
     shall be for such changes since the first year in which the 
     hospital received payment under this section), including--

       ``(I) changes in curricula, training experiences, and types 
     of training programs, and benefits that have resulted from 
     such changes; and
       ``(II) changes for purposes of training the residents in 
     the measurement and improvement of the quality and safety of 
     patient care.

       ``(v) The numbers of residents described in subparagraph 
     (C) who completed their residency training at the end of such 
     residency academic year and care for children within the 
     borders of the service area of the hospital or within the 
     borders of the State in which the hospital is located. Such 
     numbers shall be disaggregated with respect to residents who 
     completed residencies in general pediatrics or internal 
     medicine/pediatrics, subspecialty residencies, and dental 
     residencies.
       ``(C) Residents.--The residents described in this 
     subparagraph are those who--
       ``(i) are in full-time equivalent resident training 
     positions in any training program sponsored by the hospital; 
     or
       ``(ii) are in a training program sponsored by an entity 
     other than the hospital, but who spend more than 75 percent 
     of their training time at the hospital.
       ``(D) Report to congress.--Not later than the end of fiscal 
     year 2011, the Secretary, acting through the Administrator of 
     the Health Resources and Services Administration, shall 
     submit a report to the Congress--
       ``(i) summarizing the information submitted in reports to 
     the Secretary under subparagraph (B);
       ``(ii) describing the results of the program carried out 
     under this section; and
       ``(iii) making recommendations for improvements to the 
     program.''.
       (c) Technical Amendments.--Section 340E of the Public 
     Health Service Act (42 U.S.C. 256e) is further amended--
       (1) in subsection (c)(2)(E)(ii), by striking ``described in 
     subparagraph (C)(ii)'' and inserting ``applied under section 
     1886(d)(3)(E) of the Social Security Act for discharges 
     occurring during the preceding fiscal year'';
       (2) in subsection (e)(2), by striking the first sentence; 
     and
       (3) in subsection (e)(3), by striking ``made to pay'' and 
     inserting ``made and pay''.

  The amendment was ordered to be engrossed and the bill to be read a 
third time.
  The bill (H.R. 5574), as amended, was read the third time and passed.

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