One Hundred Thirteenth Congress of the United States of America
Begun and held at the City of Washington on Friday, the third day of January, two thousand and fourteen
IN THE SENATE OF THE UNITED STATES
To amend the Public Health Service Act to reauthorize support for graduate medical education programs in children’s hospitals.
This Act may be cited as
Children’s Hospital GME Support Reauthorization Act of 2013.
Program of payments to children’s hospitals that operate graduate medical education programs
Section 340E of the Public Health Service Act (42 U.S.C. 256e) is amended—
in subsection (a),
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
in subsection (f)—
in paragraph (1)(A)—
in clause (iii), by striking
in clause (iv), by striking the period and inserting
; and; and
by adding at the end the following:
for each of fiscal years 2014 through 2018, $100,000,000.
in paragraph (2)—
in subparagraph (C), by striking
in subparagraph (D), by striking the period and inserting
; and; and
by adding at the end the following:
for each of fiscal years 2014 through 2018, $200,000,000.
Report to Congress
Section 340E(b)(3)(D) of the Public Health Service Act
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.
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:
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).
To qualify to receive payments under paragraph (1), a hospital shall be a free-standing hospital—
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;
whose inpatients are predominantly individuals under 18 years of age;
that has an approved medical residency training program as defined in section 1886(h)(5)(A) of the Social Security Act; and
that is not otherwise qualified to receive payments under this section or section 1886(h) of the Social Security Act.
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.
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).
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).
A hospital receiving payments under this subsection shall be subject to the reporting requirements under subsection (b)(3).
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).
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.
Speaker of the House of Representatives
Vice President of the United States and President of the Senate