`[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5574 Reported in House (RH)]







                                                 Union Calendar No. 284
109th CONGRESS
  2d Session
                                H. R. 5574

                          [Report No. 109-508]

   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

                             June 20, 2006

                      Additional sponsor: Mr. Ross

                             June 20, 2006

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
[For text of introduced bill, see copy of bill as introduced on June 9, 
                                 2006]

_______________________________________________________________________

                                 A BILL


 
   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 (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, $100,000,000.''; and
            (3) 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, 
                $200,000,000.''.
    (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.--
                            ``(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 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
            (3) in subsection (e)(3), by striking ``made to pay'' and 
        inserting ``made and pay''.
                                                 Union Calendar No. 284

109th CONGRESS

  2d Session

                               H. R. 5574

                          [Report No. 109-508]

_______________________________________________________________________

                                 A BILL

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

_______________________________________________________________________

                             June 20, 2006

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed`