[Congressional Record Volume 160, Number 52 (Tuesday, April 1, 2014)]
[House]
[Pages H2782-H2784]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
CHILDREN'S HOSPITAL GME SUPPORT REAUTHORIZATION ACT OF 2013
Mr. PITTS. Mr. Speaker, I move to suspend the rules and pass the bill
(S. 1557) to amend the Public Health Service Act to reauthorize support
for graduate medical education programs in children's hospitals.
The Clerk read the title of the bill.
The text of the bill is 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--
[[Page H2783]]
(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.''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Pennsylvania (Mr. Pitts) and the gentleman from Texas (Mr. Gene Green)
each will control 20 minutes.
The Chair recognizes the gentleman from Pennsylvania.
General Leave
Mr. PITTS. Mr. Speaker, I ask unanimous consent that all Members may
have 5 legislative days in which to revise and extend their remarks and
insert extraneous materials in the Record on the bill.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Pennsylvania?
There was no objection.
Mr. PITTS. Mr. Speaker, I yield myself such time as I may consume.
I am glad that, today, we will pass a bill that will help keep
American children healthy. Today, the House considers S. 1557, the
Children's Hospital GME Support Reauthorization Act of 2013. This is
companion legislation to my own bill, H.R. 297, which passed the House
at the beginning of this Congress. I am pleased that we have worked out
the slight differences between the bills and that we can now
reauthorize an important program that makes sure our Nation has enough
doctors trained to treat children.
The Children's Hospital Graduate Medical Education Program helps
encourage more young doctors to pursue this important specialty.
Without it, we would certainly see fewer medical professionals enter
pediatrics and pediatric subspecialties.
{time} 1800
Children need doctors trained just to treat them. Nationwide, this
program supports the training of more than 5,000 doctors. Locally, in
my area of Pennsylvania, the Children's Hospital of Philadelphia
participates in the program.
I have had the privilege of visiting the hospital a number of times
and meeting with the young patients and the doctors learning how to
treat them.
I am proud to have worked on this legislation with Energy and
Commerce Health Subcommittee Ranking Member Frank Pallone. We
originally introduced this bill in the 112th Congress. It has been a
long road. I am glad we can finally send this bill to the President for
his signature.
This is yet another bipartisan bill that we have successfully moved
through the Health Subcommittee. It is proof that, despite our
differences, we can find common ground and work together on legislation
in a bipartisan way to help Americans stay healthy.
I would like to especially thank Monica Volante on my staff, as well
as the staff of the Health Subcommittee, especially Brenda Destro and
Katie Novaria, who worked tirelessly on this legislation.
I urge all of my colleagues to support this bill, and I reserve the
balance of my time.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I
may consume.
I rise today in support of the Children's Hospitals GME Support
Reauthorization Act, which reauthorizes the Children's Hospital
Graduate Medical Education Program through 2018.
The Children's Hospital Graduate Medical Education Program provides
vital funding to support the training of pediatricians and pediatric
specialists in our children's hospitals.
Continued strong support for CHGME is essential to maintain this
investment in our children's health care. Reauthorizing the Children's
Hospital Graduate Medical Education Program represents a commitment to
ensuring that children throughout the country have access to the
quality care they need.
Since its creation in 1999, this program has increased the number of
pediatric health care providers, addressed critical shortages in
pediatric specialty care, and improved access to necessary care.
The CHGME recipient hospitals represent less than 1 percent of all
hospitals, yet train half of all the Nation's pediatricians and
pediatric specialists.
As a cosponsor of the House bill that passed in 2013 and a long
advocate for the Children's Hospital Graduate Medical Education
Program, I applaud this bipartisan, bicameral effort to preserve and
strengthen this important program.
I want to recognize and applaud the leadership of Ranking Member
Frank Pallone and Chairman Pitts on this legislation in the House.
I also want to acknowledge the sponsors of the measure we are
considering today, Senators Casey and Isakson. I also commend Chairman
Upton, Chairman Harkin, and Ranking Member Alexander for making it
possible for the House to consider this bipartisan legislation today.
[[Page H2784]]
I urge my colleagues to join me in supporting S. 1557 and sending
this legislation to the President for his signature.
I yield back the balance of my time.
Mr. Speaker, I rise today in support of the Children's Hospitals GME
Support Reauthorization Act, which reauthorizes the Children's
Hospitals Graduate Medical Education (CHGME) program through 2018.
The CHGME program provides vital funding to support the training of
pediatricians and pediatric specialists in children's hospitals.
Continued strong support for CHGME is essential to maintain this
investment in children's health care. Reauthorizing CHGME represents a
commitment to ensuring that children throughout the country have access
to the quality care they need.
Since its creation in 1999, CHGME has increased the number of
pediatric health care providers, addressed critical shortages in
pediatric specialty care and improved access to necessary care.
The CHGME recipient hospitals represent less than one percent of all
hospitals, yet train half of all the nation's pediatricians and
pediatric specialists.
As a co-sponsor of the House bill that passed in February 2013 and a
longtime advocate for the CHGME program, I applaud this bipartisan,
bicameral effort to preserve and strengthen this important program.
Mr. PITTS. Mr. Speaker, I am very pleased to ask all Members to
support S. 1557, very important legislation with bipartisan support,
and I yield back the balance of my time.
Mr. WAXMAN. Mr. Speaker, I rise to support S. 1557, the Children's
Hospital GME Support Reauthorization Act of 2013.
S. 1557 reauthorizes the children's hospital graduate medical
education--or CHGME--program through fiscal year 2018 at an
authorization level of $300 million per year. The legislation also
makes two important changes to the program. It provides for a limited
expansion of the CHGME program to include children's psychiatric
hospitals and other children's hospitals that have been unable--to
date--to participate in the program for technical reasons. It also
would allow the Secretary of Health and Human Services to redistribute
any remaining funding set aside for the newly-eligible hospitals that
goes unused based upon quality measures.
This program provides ongoing and consistent financial support to
hospitals such as Children's Hospital of Los Angeles for the training
of doctors who want to specialize in pediatrics. Over the years, the
CHGME program has been enormously successful in reversing the
significant decline in the number of pediatrician trainees across the
country. Indeed, today, children's hospitals nationwide that are
supported by the program train 49% of all pediatricians and 51% of all
pediatric specialists.
Not surprisingly, the CHGME program has a decade-long history of
bipartisan support. The program was first established in 1999 and has
subsequently been reauthorized on two occasions. During the 112th
Congress and earlier this Congress, the House passed stand alone
legislation that would have reauthorized the CHGME program for another
five years.
I am sure that Members on both sides of the aisle agree we want to
make certain this important program remains in place, and we want to
send a strong message about the importance of fully funding it.
I want to recognize and applaud the leadership of Ranking Member
Pallone and Chairman Pitts on CHGME legislation in the House. I also
want to acknowledge the sponsors of the measure we are considering
today--Senators Casey and Isakson. And, of course, I commend Chairman
Upton, Chairman Harkin, and Ranking Member Alexander for making it
possible for the House to consider this bipartisan legislation today.
I urge my colleagues to join me in supporting S. 1557 and sending
this legislation to the President for his signature.
Mr. GINGREY of Georgia. Mr. Speaker, I rise in support of S. 1557,
the Children's Hospital GME Support Reauthorization Act of 2013. This
bill extends and reauthorizes funding for those children's hospitals
with approved graduate medical residency training program. We must act
now to promote and strengthen our country's pediatric workforce.
It is no secret that our country faces a growing shortage of
physicians. It is important for Congress to recognize that investments
in our future doctors will be essential to ensuring patient access and
quality health outcomes. If we do not have the physicians to care for
our sick and needy, no amount of technological advancement will be
enough to provide health care services for everyone. The vote today
recognizes this fact, and will confirm our desire to provide adequate
future access to pediatric care.
As a physician of over 30 years, and one who has delivered over 5,200
babies, I understand the tremendous impact that pediatricians have on
the health of our children. The bipartisan support and engagement of
this legislation points to its truly important need and I urge my
colleagues today to vote to ensure that an adequate funding stream is
available to train tomorrow's pediatricians.
For these important reasons, I support S. 1557.
Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Speaker, I rise in support of
S. 1557, the Children's Hospital Graduate Medical Education Support
Reauthorization Act. Passed in the Senate in November, this legislation
is vital to our children's health care system because it provides
freestanding children's hospitals with federal funding for graduate
medical education.
In my district, Children's Medical Center of Dallas trains 230
medical residents each year and is integral in addressing the current
physician shortage in Texas. CHGME is vital to the continuation of the
training program at Children's and at pediatric hospitals nationwide.
CHGME recipient hospitals make up only one percent of all hospitals and
train nearly half of all pediatricians.
Hospitals like Children's provide coordinated care for our nation's
sickest kids regardless of their family's ability to pay. The CHGME
program ensures that pediatricians and pediatric specialists are
properly trained to care for these children, covering basic physician
visits to complex, life-threatening cancers.
Since 1999, CHGME has helped to address the gap in federal support
for pediatric training and specialty pediatric care. The CHGME program
is a critical investment in strengthening our healthcare workforce and
is essential to maintaining the gains in pediatric care. I urge my
colleagues to support the CHGME program and vote in favor of S. 1557,
the Children's Hospital Graduate Medical Education Support
Reauthorization Act.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Pennsylvania (Mr. Pitts) that the House suspend the
rules and pass the bill, S. 1557.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill was passed.
A motion to reconsider was laid on the table.
____________________