I 

111TH CONGRESS 

1ST SESSION H. R. 2033 

To apply an alternative payment amount under the Medicare Program for 

certain graduate medical education programs established to train residents displaced by natural disasters. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 22, 2009 

Mr. CASSIDY (for himself, Mr. ALEXANDER, Mr. BOUSTANY, Mr. CAO, Mr. 

FLEMING, Mr. MELANCON, and Mr. SCALISE) introduced the following 

bill; which was referred to the Committee on Ways and Means, and in 

addition to the Committee on Energy and Commerce, for a period to be 

subsequently determined by the Speaker, in each case for consideration 

of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To apply an alternative payment amount under the Medicare 

Program for certain graduate medical education programs established to train residents displaced by natural 

disasters. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


SMARTINEZ on PROD1PC64 with BILLS
2 

•HR 2033 IH

1 SECTION 1. ALTERNATIVE PAYMENT AMOUNTS FOR GRAD2 UATE MEDICAL EDUCATION PROGRAMS ES3 TABLISHED TO TRAIN RESIDENTS DIS4 PLACED BY NATURAL DISASTERS. 

5 (a) IN GENERAL.—Notwithstanding any other provi6 sion of law, in applying section 1886(h) of the Social Secu7 rity Act (42 U.S.C. 1395ww(h)), and any regulations im8 plementing such section, with respect to an eligible hos9 pital for a cost reporting period beginning on or after July 

10 1, 2005, the Secretary of Health and Human Services 

11 shall provide for payments for direct graduate education 

12 costs in accordance with subsection (c) for such hospital 

13 and cost reporting period. 

14 (b) ELIGIBLE HOSPITAL DEFINED.—In this section, 

15 the term ‘‘eligible hospital’’ means a hospital that— 

16 (1) did not have an approved medical residency 

17 training program as defined under section 

18 1886(h)(5)(A) of the Social Security Act (42 U.S.C. 

19 1395ww(h)(5)(A)) before the date of a presidential 

20 declaration of major disaster issued under section 

21 401 of the Robert T. Stafford Disaster Relief and 

22 Emergency Assistance Act; 

23 (2) first participated in such a program to edu24 cate residents displaced from a graduate medical 

25 education program impacted by such disaster; and 


SMARTINEZ on PROD1PC64 with BILLS
3 

•HR 2033 IH

1 (3) is located in a wage area, as defined by the 

2 Secretary, that is in, or immediately adjacent to, an 

3 area for which such disaster was declared. 

4 (c) PAYMENT TO ELIGIBLE HOSPITALS.—The pay5 ment amount for an eligible hospital for a cost reporting 

6 period in which the hospital operates a graduate medical 

7 education program referred to in subsection (b)(2) shall 

8 be— 

9 (1) for the first such cost reporting period, the 

10 reasonable costs (as determined based on rules ap11 plied in determining reasonable costs under section 

12 1886(h)(2)(A) of the Social Security Act (42 U.S.C. 

13 1395ww(h)(2)(A))) incurred by the hospital for such 

14 program; 

15 (2) for the second such cost reporting period, 

16 computed based on an alternative FTE resident 

17 amount calculated as described in section 

18 1886(h)(2)(A) of the Social Security Act (42 U.S.C. 

19 1395ww(h)(2)(A)), but using the reasonable costs 

20 incurred by the hospital for such program during 

21 such second cost reporting period and the number of 

22 FTE residents (as described in paragraphs 

23 (3)(B)(ii) and (4)(E) of section 1886(h) of the So24 cial Security Act (42 U.S.C. 1395ww(h))) in the 

25 program for such second cost reporting period; and 


SMARTINEZ on PROD1PC64 with BILLS
4 

•HR 2033 IH

1 (3) for the third such cost reporting period and 

2 each subsequent cost reporting period, computed 

3 based on the alternative FTE resident amount under 

4 this section for the previous cost reporting period, 

5 updated and adjusted as described in section 

6 1886(h)(2)(D) of the Social Security Act (42 U.S.C. 

7 1395ww(h)(2)(D)). 

Æ 


SMARTINEZ on PROD1PC64 with BILLS