[Congressional Record Volume 159, Number 160 (Tuesday, November 12, 2013)]
[Senate]
[Page S7963]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




      CHILDREN'S HOSPITAL GME SUPPORT REAUTHORIZATION ACT OF 2013

  Ms. WARREN. Mr. President, I ask unanimous consent the Senate proceed 
to the immediate consideration of Calendar No. 227, S. 1557.
  The PRESIDING OFFICER. The clerk will report the bill by title.
  The legislative clerk read as follows:

       A bill (S. 1557) 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.
  Ms. WARREN. I ask the bill be read a third time and passed, the 
motion to reconsider be considered made and laid upon the table, with 
no intervening action or debate.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The bill (S. 1557) was ordered to be engrossed for a third reading, 
was read the third time, and passed, as follows:

                                S. 1557

       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 ``Children's Hospital GME 
     Support Reauthorization Act of 2013''.

     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 striking ``through 2005 and each 
     of fiscal years 2007 through 2011'' and inserting ``through 
     2005, each of fiscal years 2007 through 2011, and each of 
     fiscal years 2014 through 2018''; and
       (2) in subsection (f)--
       (A) in paragraph (1)(A)--
       (i) in clause (iii), by striking ``and'';
       (ii) in clause (iv), by striking the period and inserting 
     ``; and''; and
       (iii) by adding at the end the following:
       ``(v) for each of fiscal years 2014 through 2018, 
     $100,000,000.''; and
       (B) in paragraph (2)--
       (i) in subparagraph (C), by striking ``and'';
       (ii) in subparagraph (D), by striking the period and 
     inserting ``; and''; and
       (iii) by adding at the end the following:
       ``(E) for each of fiscal years 2014 through 2018, 
     $200,000,000.''.
       (b) Report to Congress.--Section 340E(b)(3)(D) of the 
     Public Health Service Act (42 U.S.C. 256e(b)(3)(D)) is 
     amended by striking ``Not later than the end of fiscal year 
     2011'' and inserting ``Not later than the end of fiscal year 
     2018''.

     SEC. 3. SUPPORT OF GRADUATE MEDICAL EDUCATION PROGRAMS IN 
                   CERTAIN HOSPITALS.

       Section 340E of the Public Health Service Act (42 U.S.C. 
     256e) is amended by adding at the end the following:
       ``(h) Additional Provisions.--
       ``(1) In general.--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).
       ``(2) Qualified hospitals.--
       ``(A) In general.--To qualify to receive payments under 
     paragraph (1), a hospital shall be a free-standing hospital--
       ``(i) 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;
       ``(ii) whose inpatients are predominantly individuals under 
     18 years of age;
       ``(iii) that has an approved medical residency training 
     program as defined in section 1886(h)(5)(A) of the Social 
     Security Act; and
       ``(iv) that is not otherwise qualified to receive payments 
     under this section or section 1886(h) of the Social Security 
     Act.
       ``(B) Establishment of residency cap.--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.
       ``(3) Payments.--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).
       ``(4) Payment amounts.--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).
       ``(5) Reporting.--A hospital receiving payments under this 
     subsection shall be subject to the reporting requirements 
     under subsection (b)(3).
       ``(6) Remaining funds.--
       ``(A) In general.--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).
       ``(B) Quality bonus system.--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.''.

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