To reauthorize the Children's Hospitals Graduate Medical Education Program.

Summary: Children's Hospitals Education Equity and Research (CHEER) Act of 2005 - Amends the Public Health Service Act to require the Secretary of Health and Human Services to make payments through FY 2010 (currently, through FY 2005) to children's hospitals for expenses associated with operating approved graduate medical residency training programs.

Excludes reductions for unused resident positions when calculating the number of full-time residents in a children's hospital's approved training program for purposes of reimbursing direct expenses.

Requires the Secretary to adjust the proportion of such a hospital's costs attributable to wages for differences in hospital wage levels by geographic area.

Authorizes appropriations through FY 2010 for direct and indirect expenses associated with operating such programs.

Requires that funds appropriated for such programs for a fiscal year remain available for obligation through the end of the succeeding fiscal year.

Limits the ability to recoup funds unless a demand for recoupment is made by the end of the fiscal year.

Sets forth an appeals procedure and limitations on retroactivity for decisions affecting the amount of payments to a hospital for such programs.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Children's Hospitals Education 
Equity and Research (CHEER) Act of 2005''.

SEC. 2. REAUTHORIZATION OF CHILDREN'S HOSPITALS GRADUATE MEDICAL 
              EDUCATION PROGRAM.

    (a) Extension of Program.--Section 340E(a) of the Public Health 
Service Act (42 U.S.C. 256e(a)) is amended by striking ``2005'' and 
inserting ``2010''.
    (b) Direct Graduate Medical Education.--Section 340E(c) of the 
Public Health Service Act (42 U.S.C. 256e(c)) is amended--
            (1) in paragraph (1)(B), by inserting ``but without giving 
        effect to section 1886(h)(7) of such Act)'' after ``section 
        1886(h)(4) of the Social Security Act''; and
            (2) in paragraph (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''.
    (c) Nature of Payments.--Section 340E(e)(3) of the Public Health 
Service Act (42 U.S.C. 256e(e)(3)) is amended by striking ``made to 
pay'' and inserting ``made and pay''.
    (d) Authorization of Appropriations.--Section 340E(f) of the Public 
Health Service Act (42 U.S.C. 256e(f)) is amended--
            (1) in paragraph (1)(A)--
                    (A) in clause (ii), by striking ``and'';
                    (B) in clause (iii), by striking the period and 
                inserting a semicolon; and
                    (C) by adding at the end the following:
                            ``(iv) for fiscal year 2006, $110,000,000; 
                        and
                            ``(v) for each of fiscal years 2007 through 
                        2010, such sums as may be necessary.''; and
            (2) in paragraph (2)--
                    (A) in the matter preceding subparagraph (A)--
                            (i) by striking ``There are hereby 
                        authorized'' and inserting ``There are 
                        authorized''; and
                            (ii) by striking ``(b)(1)(A)'' and 
                        inserting ``(b)(1)(B)'';
                    (B) in subparagraph (B), by striking ``and'';
                    (C) in subparagraph (C), by striking the period and 
                inserting a semicolon; and
                    (D) by adding at the end the following:
                    ``(D) for fiscal year 2006, $220,000,000; and
                    ``(E) for each of fiscal years 2007 through 2010, 
                such sums as may be necessary.''.
    (e) Technical Amendment.--Section 340E(e)(2) of the Public Health 
Service Act (42 U.S.C. 256e(e)(2)) is amended by striking the first 
sentence.
    (f) Extending Availability of Funds Through the Following Fiscal 
Year.--
            (1) In general.--Section 340E(f) of the Public Health 
        Service Act (42 U.S.C. 256e(f)) is amended--
                    (A) in paragraph (1)(B)--
                            (i) by inserting ``or for fiscal year 2006 
                        (or any succeeding fiscal year)'' after ``for 
                        fiscal year 2000''; and
                            (ii) by striking ``fiscal year 2001'' and 
                        inserting ``the end of the succeeding fiscal 
                        year''; and
                    (B) by adding at the end of paragraph (2) the 
                following:
        ``The amounts appropriated under this paragraph for a fiscal 
        year (beginning with fiscal year 2006) shall remain available 
        for obligation through the end of the succeeding fiscal 
        year.''.
            (2) Conforming amendment.--Section 340E(b)(2)(A) of the 
        Public Health Service Act (42 U.S.C. 256e(b)(2)(A)) is amended 
        by inserting before the period at the end the following: ``plus 
        the funds remaining available from the previous fiscal year 
        under paragraph (1)(B) or the second sentence of paragraph (2), 
        respectively, of such subsection''.
    (g) Redistribution of Recouped Amounts.--Section 340E(e)(3) of the 
Public Health Service Act (42 U.S.C. 256e(e)(3)) is amended by striking 
``to the extent possible.'' and inserting a period and the following: 
``To the greatest extent possible, amounts recouped from a hospital are 
to be distributed to other hospitals in the same fiscal year. Unless 
there is fraud, amounts paid to a hospital without a demand for 
recoupment by the end of the fiscal year shall be final and not subject 
to recoupment.''.
    (h) Appeals Procedures.--Section 340E(e) of the Public Health 
Service Act (42 U.S.C. 256e(e)) is amended--
            (1) in paragraph (3), by striking the last sentence; and
            (2) by adding at the end the following:
            ``(4) Appeals.--
                    ``(A) In general.--A decision affecting the amount 
                payable to a hospital pursuant to this section shall--
                            ``(i) be subject to review under section 
                        1878 of the Social Security Act in the same 
                        manner as final determinations of the amount of 
                        payment under section 1886(d) of such Act are 
                        subject to review; and
                            ``(ii) be handled expeditiously so that the 
                        review decision is reflected in the final 
                        reconciliation for the year in which the appeal 
                        is made.
                    ``(B) Limitation.--A review decision pursuant to 
                this paragraph shall not affect payments for a fiscal 
                year prior to the fiscal year in which the review 
                decision is rendered.
                    ``(C) Application to subsequent fiscal years.--The 
                Secretary shall apply a review decision under this 
                paragraph in determining the amount of payment for the 
                appealing hospital in the fiscal year in which the 
                decision is rendered and in subsequent fiscal years, 
                unless the law at issue in the review decision is 
                amended or there are material differences between the 
                facts for the fiscal year for which the review decision 
                is rendered and the fiscal year for which payment is 
                made. Nothing in this section shall be construed to 
                prohibit a hospital from seeking review of similar 
                determinations in subsequent fiscal years.''.