I 

109TH CONGRESS 

2D SESSION H. R. 5574 

To amend the Public Health Service Act to reauthorize support for graduate 

medical education programs in children’s hospitals. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 9, 2006 

Mr. DEAL of Georgia (for himself, Mr. BROWN of Ohio, Mr. MARKEY, Mr. 

GENE GREEN of Texas, Ms. BALDWIN, Mr. PITTS, Mr. RUSH, Mr. 

RADANOVICH, Mr. SHIMKUS, Mr. BURGESS, Mr. BASS, Mrs. CAPPS, Mr. 

MURPHY, Mr. INSLEE, Mr. PALLONE, Mr. GILLMOR, Mrs. BONO, Mr. 

UPTON, Mr. HALL, Mr. WAXMAN, and Mr. WYNN) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to reauthorize support for graduate medical education programs in children’s hospitals. 

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. 

4 This Act may be cited as the ‘‘Children’s Hospital 

5 GME Support Reauthorization Act of 2006’’. 


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1 SEC. 2. PROGRAM OF PAYMENTS TO CHILDREN’S HOS2 PITALS THAT OPERATE GRADUATE MEDICAL 

3 EDUCATION PROGRAMS. 

4 (a) IN GENERAL.—Section 340E of the Public 

5 Health Service Act (42 U.S.C. 256e) is amended— 

6 (1) in subsection (a), by inserting ‘‘and each of 

7 fiscal years 2007 through 2011’’ after ‘‘for each of 

8 fiscal years 2000 through 2005’’; 

9 (2) in subsection (f)(1)(A)— 

10 (A) in clause (ii), by striking ‘‘and’’ at the 

11 end; 

12 (B) in clause (iii), by striking the period at 

13 the end and inserting ‘‘; and’’; and 

14 (C) by adding at the end the following: 

15 ‘‘(iv) for each of fiscal years 2007 

16 through 2011, $100,000,000.’’; and 

17 (3) in subsection (f)(2)— 

18 (A) in the matter before subparagraph (A), 

19 by striking ‘‘subsection (b)(1)(A)’’ and inserting 

20 ‘‘(b)(1)(B)’’; 

21 (B) in subparagraph (B), by striking 

22 ‘‘and’’ at the end; 

23 (C) in subparagraph (C), by striking the 

24 period at the end and inserting ‘‘; and’’; and 

25 (D) by adding at the end the following: 


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1 ‘‘(D) for each of fiscal years 2007 through 

2 2011, $200,000,000.’’. 

3 (b) REDUCTION IN PAYMENTS FOR FAILURE TO

4 FILE ANNUAL REPORT.—Subsection (b) of section 340E 

5 of the Public Health Service Act (42 U.S.C. 256e) is 

6 amended— 

7 (1) in paragraph (1), in the matter before sub8 paragraph (A), by striking ‘‘paragraph (2)’’ insert9 ing ‘‘paragraphs (2) and (3)’’; and 

10 (2) by adding at the end the following: 

11 ‘‘(3) ANNUAL REPORTING REQUIRED.— 

12 ‘‘(A) REDUCTION IN PAYMENT FOR FAIL13 URE TO REPORT.— 

14 ‘‘(i) IN GENERAL.—The amount pay15 able under this section to a children’s hos16 pital for a fiscal year (beginning with fiscal 

17 year 2008 and after taking into account 

18 paragraph (2)) shall be reduced by 25 per19 cent if the Secretary determines that— 

20 ‘‘(I) the hospital has failed to 

21 provide the Secretary, as an adden22 dum to the hospital’s application 

23 under this section for such fiscal year, 

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1 graph (B) for the previous fiscal year; 

2 or 

3 ‘‘(II) such report fails to provide 

4 the information required under any 

5 clause of such subparagraph. 

6 ‘‘(ii) NOTICE AND OPPORTUNITY TO

7 PROVIDE MISSING INFORMATION.—Before 

8 imposing a reduction under clause (i) on 

9 the basis of a hospital’s failure to provide 

10 information described in clause (i)(II), the 

11 Secretary shall provide notice to the hos12 pital of such failure and the Secretary’s in13 tention to impose such reduction and shall 

14 provide the hospital with the opportunity 

15 to provide the required information within 

16 a period of 30 days beginning on the date 

17 of such notice. If the hospital provides 

18 such information within such period, no re19 duction shall be made under clause (i) on 

20 the basis of the previous failure to provide 

21 such information. 

22 ‘‘(B) ANNUAL REPORT.—The report re23 quired under this subparagraph for a children’s 

24 hospital for a fiscal year is a report that in25 cludes (in a form and manner specified by the 


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1 Secretary) the following information relating to 

2 the residency training program sponsored by 

3 the hospital and supported under this section 

4 for the residency academic year completed im5 mediately prior to such fiscal year: 

6 ‘‘(i) The types of resident training 

7 programs that the hospital sponsored, such 

8 as general pediatrics, internal medicine/pe9 diatrics, and pediatric subspecialties, in10 cluding both medical subspecialties cer11 tified by the American Board of Pediatrics 

12 (such as pediatric gastroenterology) and 

13 non-medical subspecialties approved by 

14 other medical certification boards (such as 

15 pediatric surgery). 

16 ‘‘(ii) The number of full-time equiva17 lent resident training positions in each 

18 training program sponsored by the hos19 pital, the number of such positions the 

20 hospital recruited to fill, and the number 

21 of such positions filled. 

22 ‘‘(iii) The types of training that the 

23 hospital provided for residents in its own 

24 sponsored programs related to the health 

25 care needs of different populations, such as 


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1 children who are underserved for reasons 

2 of family income or geographic location, in3 cluding rural, exurban, and urban areas. 

4 ‘‘(iv) The changes in residency train5 ing the hospital has made during such resi6 dency academic year (except that the first 

7 report submitted by the hospital under this 

8 subparagraph shall be for such changes 

9 since the first year in which the hospital 

10 received payment under this section), in11 cluding— 

12 ‘‘(I) changes in curricula and 

13 types of training programs, and bene14 fits that have resulted from such 

15 changes; and 

16 ‘‘(II) changes for purposes of 

17 training the residents in its own spon18 sored programs in the measurement 

19 and improvement of the quality and 

20 safety of patient care. 

21 ‘‘(v) The numbers of residents who, 

22 upon completion of a hospital’s sponsored 

23 training program at the end of such resi24 dency academic year, care for children 

25 within the borders of the service area of 


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1 the hospital or within the borders of the 

2 State in which the hospital is located. Such 

3 numbers shall be disaggregated with re4 spect to residents who completed initial 

5 board certification, subspecialty 

6 residencies, and dental residencies. 

7 ‘‘(C) REPORT TO CONGRESS.—Not later 

8 than the end of fiscal year 2011, the Secretary, 

9 acting through the Administrator of the Health 

10 Resources and Services Administration, shall 

11 submit a report to the Congress— 

12 ‘‘(i) summarizing the information sub13 mitted in reports to the Secretary under 

14 subparagraph (B); 

15 ‘‘(ii) describing the results of the pro16 gram carried out under this section; and 

17 ‘‘(iii) making recommendations for 

18 improvements to the program.’’. 

19 (c) TECHNICAL AMENDMENTS.—Section 340E of the 

20 Public Health Service Act (42 U.S.C. 256e) is further 

21 amended— 

22 (1) in subsection (c)(2)(E)(ii), by striking ‘‘de23 scribed in subparagraph (C)(ii)’’ and inserting ‘‘ap24 plied under section 1886(d)(3)(E) of the Social SeVerDate Aug 31 2005 23:45 Jun 09, 2006 Jkt 049200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H5574.IH H5574

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1 curity Act for discharges occurring during the pre2 ceding fiscal year’’; 

3 (2) in subsection (e)(2), by striking the first 

4 sentence; and 

5 (3) in subsection (e)(3), by striking ‘‘made to 

6 pay’’ and inserting ‘‘made and pay’’. 

Æ 


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