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[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 1557 Enrolled Bill (ENR)]

        S.1557

                     One Hundred Thirteenth Congress

                                 of the

                        United States of America

                          AT THE SECOND SESSION

           Begun and held at the City of Washington on Friday,
           the third day of January, two thousand and fourteen

                                 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 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 
    $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 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.''.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.
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