H. R. 5574

One Hundred Ninth Congress

of the

United States of America 

AT THE SECOND SESSION 

Begun and held at the City of Washington on Tuesday, 

the third day of January, two thousand and six 

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 2006’’. 

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 inserting ‘‘and each of fiscal years 

2007 through 2011’’ after ‘‘for each of fiscal years 2000 through 

2005’’; 

(2) in subsection (e)(1), by striking ‘‘26’’ and inserting ‘‘12’’; 

(3) in subsection (f)(1)(A)— 

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

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

and inserting ‘‘; and’’; and 

(C) by adding at the end the following: 

‘‘(iv) for each of fiscal years 2007 through 2011, 

$110,000,000.’’; and 

(4) in subsection (f)(2)— 

(A) in the matter before subparagraph (A), by striking 

‘‘subsection (b)(1)(A)’’ and inserting ‘‘subsection (b)(1)(B)’’; 

(B) in subparagraph (B), by striking ‘‘and’’ at the end; 

(C) in subparagraph (C), by striking the period at 

the end and inserting ‘‘; and’’; and 

(D) by adding at the end the following: 

‘‘(D) for each of fiscal years 2007 through 2011, 

$220,000,000.’’. 

(b) REDUCTION IN PAYMENTS FOR FAILURE TO FILE ANNUAL

REPORT.—Subsection (b) of section 340E of the Public Health 

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

(1) in paragraph (1), in the matter before subparagraph 

(A), by striking ‘‘paragraph (2)’’ and inserting ‘‘paragraphs (2) 

and (3)’’; and 

(2) by adding at the end the following: 

‘‘(3) ANNUAL REPORTING REQUIRED.— 

‘‘(A) REDUCTION IN PAYMENT FOR FAILURE TO REPORT.— 
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‘‘(i) IN GENERAL.—The amount payable under this 

section to a children’s hospital for a fiscal year (beginning with fiscal year 2008 and after taking into account 

paragraph (2)) shall be reduced by 25 percent if the 

Secretary determines that— 

‘‘(I) the hospital has failed to provide the Secretary, as an addendum to the hospital’s application under this section for such fiscal year, the 

report required under subparagraph (B) for the 

previous fiscal year; or 

‘‘(II) such report fails to provide the information required under any clause of such subparagraph. 

‘‘(ii) NOTICE AND OPPORTUNITY TO PROVIDE MISSING

INFORMATION.—Before imposing a reduction under 

clause (i) on the basis of a hospital’s failure to provide 

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

shall provide notice to the hospital of such failure 

and the Secretary’s intention to impose such reduction 

and shall provide the hospital with the opportunity 

to provide the required information within a period 

of 30 days beginning on the date of such notice. If 

the hospital provides such information within such 

period, no reduction shall be made under clause (i) 

on the basis of the previous failure to provide such 

information. 

‘‘(B) ANNUAL REPORT.—The report required under this 

subparagraph for a children’s hospital for a fiscal year 

is a report that includes (in a form and manner specified 

by the Secretary) the following information for the residency academic year completed immediately prior to such 

fiscal year: 

‘‘(i) The types of resident training programs that 

the hospital provided for residents described in 

subparagraph (C), such as general pediatrics, internal 

medicine/pediatrics, and pediatric subspecialties, 

including both medical subspecialties certified by the 

American Board of Pediatrics (such as pediatric gastroenterology) and non-medical subspecialties approved 

by other medical certification boards (such as pediatric 

surgery). 

‘‘(ii) The number of training positions for residents 

described in subparagraph (C), the number of such 

positions recruited to fill, and the number of such 

positions filled. 

‘‘(iii) The types of training that the hospital provided for residents described in subparagraph (C) 

related to the health care needs of different populations, such as children who are underserved for reasons of family income or geographic location, including 

rural and urban areas. 

‘‘(iv) The changes in residency training for residents described in subparagraph (C) which the hospital 

has made during such residency academic year (except 

that the first report submitted by the hospital under 

this subparagraph shall be for such changes since the 
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first year in which the hospital received payment under 

this section), including— 

‘‘(I) changes in curricula, training experiences, 

and types of training programs, and benefits that 

have resulted from such changes; and 

‘‘(II) changes for purposes of training the residents in the measurement and improvement of 

the quality and safety of patient care. 

‘‘(v) The numbers of residents described in 

subparagraph (C) who completed their residency 

training at the end of such residency academic year 

and care for children within the borders of the service 

area of the hospital or within the borders of the State 

in which the hospital is located. Such numbers shall 

be disaggregated with respect to residents who completed residencies in general pediatrics or internal 

medicine/pediatrics, subspecialty residencies, and 

dental residencies. 

‘‘(C) RESIDENTS.—The residents described in this 

subparagraph are those who— 

‘‘(i) are in full-time equivalent resident training 

positions in any training program sponsored by the 

hospital; or 

‘‘(ii) are in a training program sponsored by an 

entity other than the hospital, but who spend more 

than 75 percent of their training time at the hospital. 

‘‘(D) REPORT TO CONGRESS.—Not later than the end 

of fiscal year 2011, the Secretary, acting through the 

Administrator of the Health Resources and Services 

Administration, shall submit a report to the Congress— 

‘‘(i) summarizing the information submitted in 

reports to the Secretary under subparagraph (B); 

‘‘(ii) describing the results of the program carried 

out under this section; and 

‘‘(iii) making recommendations for improvements 

to the program.’’. 

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

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

(1) in subsection (c)(2)(E)(ii), by striking ‘‘described in 

subparagraph (C)(ii)’’ and inserting ‘‘applied under section 

1886(d)(3)(E) of the Social Security Act for discharges occurring 

during the preceding fiscal year’’; 

(2) in subsection (e)(2), by striking the first sentence; and 
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(3) in subsection (e)(3), by striking ‘‘made to pay’’ and 

inserting ‘‘made and pay’’.

Speaker of the House of Representatives.

Vice President of the United States and

President of the Senate.