```

[113th Congress Public Law 98]
[From the U.S. Government Publishing Office]

[[Page 1139]]

       CHILDREN'S HOSPITAL GME SUPPORT REAUTHORIZATION ACT OF 2013

[[Page 128 STAT. 1140]]

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. <<NOTE: Apr. 7, 2014 -  [S. 1557]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress 
assembled, <<NOTE: Children's Hospital GME Support Reauthorization Act 
of 2013. 42 USC 201 note.>> 
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 128 STAT. 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 128 STAT. 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:
---------------------------------------------------------------------------

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

                                  <all>
```