    [United States Statutes at Large, Volume 128, 113th Congress, 2nd Session]
    [From the U.S. Government Publishing Office, www.gpo.gov]

    Public Law 113-98
    113th Congress

    An Act

    To amend the Public Health Service Act to reauthorize support for
    graduate medical education programs in children's
    hospitals. <>

    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

    [[Page 1141]]

    $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

    [[Page 1142]]

    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.''.

    Approved April 7, 2014.

    LEGISLATIVE HISTORY--S. 1557:
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    CONGRESSIONAL RECORD:
    Vol. 159 (2013):
    Nov. 12, considered and passed
    Senate.
    Vol. 160 (2014):
    Apr. 1, considered and passed House.