II

107TH CONGRESS

1ST SESSION S. 1362

To amend title XVIII of the Social Security Act and title VII of the Public

Health Service Act to expand medical residency training programs in

geriatrics, and for other purposes.

IN THE SENATE OF THE UNITED STATES

AUGUST 3, 2001

Mr. HUTCHINSON (for himself and Mr. CRAIG) introduced the following bill;

which was read twice and referred to the Committee on Finance

A BILL

To amend title XVIII of the Social Security Act and title

VII of the Public Health Service Act to expand medical

residency training programs in geriatrics, and for other

purposes.

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

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

4 (a) SHORT TITLE.—This Act may be cited as the

5 ‘‘Advancement of Geriatric Education Act of 2001’’.

6 (b) TABLE OF CONTENTS.—The table of contents of

7 this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. Disregard of certain geriatric residents and fellows against graduate

medical education limitations.
2

•S 1362 IS

Sec. 3. Extension of eligibility periods for geriatric graduate medical education.

Sec. 4. Study and report on improvement of graduate medical education.

Sec. 5. Improved funding for education and training relating to geriatrics.

1 SEC. 2. DISREGARD OF CERTAIN GERIATRIC RESIDENTS

2 AND FELLOWS AGAINST GRADUATE MEDICAL

3 EDUCATION LIMITATIONS.

4 (a) DIRECT GME.—Section 1886(h)(4)(F) of the So5 cial Security Act (42 U.S.C. 1395ww(h)(4)(F)) is amend6 ed by adding at the end the following new clause:

7 ‘‘(iii) INCREASE IN LIMITATION FOR

8 GERIATRIC RESIDENCIES AND FELLOW9 SHIPS.—For cost reporting periods begin10 ning on or after the date that is 6 months

11 after the date of enactment of the Ad12 vancement of Geriatric Education Act of

13 2001, in applying the limitations regarding

14 the total number of full-time equivalent

15 residents in the field of allopathic or osteo16 pathic medicine under clause (i) for a hos17 pital, the Secretary shall not take into ac18 count a maximum of 5 residents enrolled

19 in a geriatric residency or fellowship pro20 gram approved by the Secretary for pur21 poses of paragraph (5)(A) to the extent

22 that the hospital increases the number of

23 geriatric residents or fellows above the

24 number of such residents or fellows for the
3

•S 1362 IS

1 hospital’s most recent cost reporting period

2 ending before the date that is 6 months

3 after the date of enactment of such Act.’’.

4 (b) INDIRECT GME.—Section 1886(d)(5)(B) of the

5 Social Security Act (42 U.S.C. 1395ww(d)(5)(B)) is

6 amended by adding at the end the following new clause:

7 ‘‘(ix) Clause (iii) of subsection (h)(4)(F) shall

8 apply to clause (v) in the same manner and for the

9 same period as such clause (iii) applies to clause (i)

10 of such subsection.’’.

11 SEC. 3. EXTENSION OF ELIGIBILITY PERIODS FOR GERI12 ATRIC GRADUATE MEDICAL EDUCATION.

13 (a) DIRECT GME.—Section 1886(h)(5)(G) of the So14 cial Security Act (42 U.S.C. 1395ww(h)(5)(G)) is amend15 ed by adding at the end the following new clause:

16 ‘‘(vi) GERIATRIC RESIDENCY AND

17 FELLOWSHIP PROGRAMS.—In the case of

18 an individual enrolled in a geriatric resi19 dency or fellowship program approved by

20 the Secretary for purposes of subpara21 graph (A), the period of board eligibility

22 and the initial residency period shall be the

23 period of board eligibility for the sub24 specialty involved, plus 1 year.’’.
4

•S 1362 IS

1 (b) CONFORMING AMENDMENT.—Section

2 1886(h)(5)(F) of the Social Security Act (42 U.S.C.

3 1395ww(h)(5)(F)) is amended by striking ‘‘subparagraph

4 (G)(v)’’ and inserting ‘‘clauses (v) and (vi) of subpara5 graph (G)’’.

6 (c) EFFECTIVE DATE.—The amendments made by

7 this section shall apply to cost reporting periods beginning

8 on or after the date that is 6 months after the date of

9 enactment of this Act.

10 SEC. 4. STUDY AND REPORT ON IMPROVEMENT OF GRAD11 UATE MEDICAL EDUCATION.

12 (a) STUDY.—The Secretary of Health and Human

13 Services shall conduct a study to determine how to im14 prove the graduate medical education programs under

15 subsections (d)(5)(B) and (h) of section 1886 of the Social

16 Security Act (42 U.S.C. 1395ww) so that such programs

17 prepare the physician workforce to serve the aging popu18 lation of the United States. Such study shall include a de19 termination of whether the establishment of an initiative

20 to encourage the development of individuals as academic

21 geriatricians would improve such programs.

22 (b) REPORT.—Not later than the date that is 6

23 months after the date of enactment of this Act, the Sec24 retary of Health and Human Services shall submit to Con25 gress a report on the study conducted under subsection
5

•S 1362 IS

1 (a) together with such recommendations for legislative and

2 administrative action as the Secretary determines appro3 priate.

4 SEC. 5. IMPROVED FUNDING FOR EDUCATION AND TRAIN5 ING RELATING TO GERIATRICS.

6 (a) GERIATRIC FACULTY FELLOWSHIPS.—Section of

7 753(c)(4) of the Public Health Service Act (42 U.S.C.

8 294c(c)(4)) is amended—

9 (1) in subparagraph (A), by striking ‘‘$50,000

10 for fiscal year 1998’’ and inserting ‘‘$75,000 for fis11 cal year 2002’’; and

12 (2) in subparagraph (B), by striking ‘‘shall not

13 exceed 5 years’’ and inserting ‘‘shall be 5 years’’.

14 (b) AUTHORIZATION OF APPROPRIATIONS.—Section

15 757 of the Public Health Service Act (42 U.S.C. 294g)

16 is amended—

17 (1) in subsection (a)—

18 (A) by striking ‘‘IN GENERAL.—There are

19 authorized’’ and inserting ‘‘AUTHORIZATION.—

20 ‘‘(1) IN GENERAL.—Except as provided in para21 graph (2), there are authorized’’; and

22 (B) by adding at the end the following:

23 ‘‘(2) EDUCATION AND TRAINING RELATING TO

24 GERIATRICS.—There are authorized to be appro25 priated to carry out section 753 such sums as may
6

•S 1362 IS

1 be necessary for each of fiscal years 2002 through

2 2006.’’; and

3 (2) in subsection (b)—

4 (A) in paragraph (1)—

5 (i) in subparagraph (B), by striking

6 ‘‘and’’ at the end; and

7 (ii) by striking subparagraph (C) and

8 inserting the following:

9 ‘‘(C) not less than $22,631,000 for awards

10 of grants and contracts under—

11 ‘‘(i) section 753 for fiscal years 1998

12 through 2001; and

13 ‘‘(ii) sections 754 and 755 for fiscal

14 years 1998 through 2002; and

15 ‘‘(D) for awards of grants and contracts

16 under section 753 after fiscal year 2001—

17 ‘‘(i) in 2002, not less than

18 $20,000,000;

19 ‘‘(ii) in 2003, not less than

20 $24,000,000;

21 ‘‘(iii) in 2004, not less than

22 $28,000,000;

23 ‘‘(iv) in 2005, not less than

24 $32,000,000; and
7

•S 1362 IS

1 ‘‘(v) in 2006, not less than

2 $36,000,000.’’;

3 (B) in paragraph (2), by striking ‘‘sub4 paragraphs (A) through (C)’’ and inserting

5 ‘‘subparagraphs (A) through (D)’’; and

6 (C) in paragraph (3), by striking ‘‘sub7 paragraphs (A) through (C) of paragraph (2)’’

8 and inserting ‘‘subparagraphs (A) through (D)

9 of paragraph (1)’’.

10 (c) EFFECTIVE DATE.—The amendments made by

11 this section shall take effect on October 1, 2001.

Æ