PUBLIC LAW 109–307—OCT. 6, 2006 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.

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 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.—

Children’s

Hospital GME

Support

Reauthorization

Act of 2006.

42 USC 201 note.

Oct. 6, 2006

[H.R. 5574]

120 STAT. 1722 PUBLIC LAW 109–307—OCT. 6, 2006

‘‘(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

PUBLIC LAW 109–307—OCT. 6, 2006 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

120 STAT. 1724 PUBLIC LAW 109–307—OCT. 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.

Æ

(3) in subsection (e)(3), by striking ‘‘made to pay’’ and

inserting ‘‘made and pay’’.

Approved October 6, 2006.