IIB 

109TH CONGRESS 

2D SESSION H. R. 5574 

IN THE SENATE OF THE UNITED STATES 

JUNE 22, 2006 

Received; read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

AN ACT 

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, 


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1 SECTION 1. SHORT TITLE. 

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

3 GME Support Reauthorization Act of 2006’’. 

4 SEC. 2. PROGRAM OF PAYMENTS TO CHILDREN’S HOS5 PITALS THAT OPERATE GRADUATE MEDICAL 

6 EDUCATION PROGRAMS. 

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

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

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

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

11 fiscal years 2000 through 2005’’; 

12 (2) in subsection (f)(1)(A)— 

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

14 end; 

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

16 the end and inserting ‘‘; and’’; and 

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

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

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

20 (3) in subsection (f)(2)— 

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

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

23 ‘‘subsection (b)(1)(B)’’; 

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

25 ‘‘and’’ at the end; 


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

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

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

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

5 2011, $200,000,000.’’. 

6 (b) REDUCTION IN PAYMENTS FOR FAILURE TO

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

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

9 amended— 

10 (1) in paragraph (1), in the matter before sub11 paragraph (A), by striking ‘‘paragraph (2)’’ and in12 serting ‘‘paragraphs (2) and (3)’’; and 

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

14 ‘‘(3) ANNUAL REPORTING REQUIRED.— 

15 ‘‘(A) REDUCTION IN PAYMENT FOR FAIL16 URE TO REPORT.— 

17 ‘‘(i) IN GENERAL.—The amount pay18 able under this section to a children’s hos19 pital for a fiscal year (beginning with fiscal 

20 year 2008 and after taking into account 

21 paragraph (2)) shall be reduced by 25 per22 cent if the Secretary determines that— 

23 ‘‘(I) the hospital has failed to 

24 provide the Secretary, as an adden25 dum to the hospital’s application 


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1 under this section for such fiscal year, 

2 the report required under subpara3 graph (B) for the previous fiscal year; 

4 or 

5 ‘‘(II) such report fails to provide 

6 the information required under any 

7 clause of such subparagraph. 

8 ‘‘(ii) NOTICE AND OPPORTUNITY TO

9 PROVIDE MISSING INFORMATION.—Before 

10 imposing a reduction under clause (i) on 

11 the basis of a hospital’s failure to provide 

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

13 Secretary shall provide notice to the hos14 pital of such failure and the Secretary’s in15 tention to impose such reduction and shall 

16 provide the hospital with the opportunity 

17 to provide the required information within 

18 a period of 30 days beginning on the date 

19 of such notice. If the hospital provides 

20 such information within such period, no re21 duction shall be made under clause (i) on 

22 the basis of the previous failure to provide 

23 such information. 

24 ‘‘(B) ANNUAL REPORT.—The report re25 quired under this subparagraph for a children’s 


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1 hospital for a fiscal year is a report that in2 cludes (in a form and manner specified by the 

3 Secretary) the following information for the 

4 residency academic year completed immediately 

5 prior to such fiscal year: 

6 ‘‘(i) The types of resident training 

7 programs that the hospital provided for 

8 residents described in subparagraph (C), 

9 such as general pediatrics, internal medi10 cine/pediatrics, and pediatric subspecial11 ties, including both medical subspecialties 

12 certified by the American Board of Pediat13 rics (such as pediatric gastroenterology) 

14 and non-medical subspecialties approved by 

15 other medical certification boards (such as 

16 pediatric surgery). 

17 ‘‘(ii) The number of training positions 

18 for residents described in subparagraph 

19 (C), the number of such positions recruited 

20 to fill, and the number of such positions 

21 filled. 

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

23 hospital provided for residents described in 

24 subparagraph (C) 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 and urban areas. 

4 ‘‘(iv) The changes in residency train5 ing for residents described in subparagraph 

6 (C) which the hospital has made during 

7 such residency academic year (except that 

8 the first report submitted by the hospital 

9 under this subparagraph shall be for such 

10 changes since the first year in which the 

11 hospital received payment under this sec12 tion), including— 

13 ‘‘(I) changes in curricula, train14 ing experiences, and types of training 

15 programs, and benefits that have re16 sulted from such changes; and 

17 ‘‘(II) changes for purposes of 

18 training the residents in the measure19 ment and improvement of the quality 

20 and safety of patient care. 

21 ‘‘(v) The numbers of residents de22 scribed in subparagraph (C) who com23 pleted their residency training at the end 

24 of such residency academic year and care 

25 for children within the borders of the servVerDate Aug 31 2005 04:26 Jun 23, 2006 Jkt 049200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H5574.RFS H5574

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1 ice area of the hospital or within the bor2 ders of the State in which the hospital is 

3 located. Such numbers shall be 

4 disaggregated with respect to residents 

5 who completed residencies in general pedi6 atrics or internal medicine/pediatrics, sub7 specialty residencies, and dental 

8 residencies. 

9 ‘‘(C) RESIDENTS.—The residents described 

10 in this subparagraph are those who— 

11 ‘‘(i) are in full-time equivalent resi12 dent training positions in any training pro13 gram sponsored by the hospital; or 

14 ‘‘(ii) are in a training program spon15 sored by an entity other than the hospital, 

16 but who spend more than 75 percent of 

17 their training time at the hospital. 

18 ‘‘(D) REPORT TO CONGRESS.—Not later 

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

20 acting through the Administrator of the Health 

21 Resources and Services Administration, shall 

22 submit a report to the Congress— 

23 ‘‘(i) summarizing the information sub24 mitted in reports to the Secretary under 

25 subparagraph (B); 


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1 ‘‘(ii) describing the results of the pro2 gram carried out under this section; and 

3 ‘‘(iii) making recommendations for 

4 improvements to the program.’’. 

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

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

7 amended— 

8 (1) in subsection (c)(2)(E)(ii), by striking ‘‘de9 scribed in subparagraph (C)(ii)’’ and inserting ‘‘ap10 plied under section 1886(d)(3)(E) of the Social Se11 curity Act for discharges occurring during the pre12 ceding fiscal year’’; 

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

14 sentence; and 

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

16 pay’’ and inserting ‘‘made and pay’’. 

Passed the House of Representatives June 21, 2006. 

Attest: KAREN L. HAAS, 

Clerk. 


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