[109th Congress Public Law 307]
[From the U.S. Government Printing Office]


[DOCID: f:publ307.109]

[[Page 120 STAT. 1721]]

Public Law 109-307
109th Congress

                                 An Act


 
   To amend the Public Health Service Act to reauthorize support for 
           graduate medical education programs in children's 
            hospitals. <<NOTE: Oct. 6, 2006 -  [H.R. 5574]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress <<NOTE: Children's Hospital GME 
Support Reauthorization Act of 2006. 42 USC 201 note.>> assembled,

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.--

[[Page 120 STAT. 1722]]

                          ``(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

[[Page 120 STAT. 1723]]

                      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

[[Page 120 STAT. 1724]]

            (3) in subsection (e)(3), by striking ``made to pay'' and 
        inserting ``made and pay''.

    Approved October 6, 2006.

LEGISLATIVE HISTORY--H.R. 5574 (S. 285):
---------------------------------------------------------------------------

HOUSE REPORTS: No. 109-508 (Comm. on Energy and Commerce).
CONGRESSIONAL RECORD, Vol. 152 (2006):
            June 21, considered and passed House.
            Sept. 26, considered and passed Senate, amended.
            Sept. 28, House concurred in Senate amendment.

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