IB 

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. 


ccoleman on PROD1PC71 with BILLS
2 

•HR 5574 RH

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’’. 

6 SEC. 2. PROGRAM OF PAYMENTS TO CHILDREN’S HOS7 PITALS THAT OPERATE GRADUATE MEDICAL 

8 EDUCATION PROGRAMS. 

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

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

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

12 fiscal years 2007 through 2011’’ after ‘‘for each of fis13 cal years 2000 through 2005’’; 

14 (2) in subsection (f)(1)(A)— 

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

16 end; 

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

18 the end and inserting ‘‘; and’’; and 

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

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

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

22 (3) in subsection (f)(2)— 

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

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

25 ‘‘subsection (b)(1)(B)’’; 


ccoleman on PROD1PC71 with BILLS
3 

•HR 5574 RH

1 (B) in subparagraph (B), by striking ‘‘and’’ 

2 at the end; 

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

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

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

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

7 2011, $200,000,000.’’. 

8 (b) REDUCTION IN PAYMENTS FOR FAILURE TO FILE

9 ANNUAL REPORT.—Subsection (b) of section 340E of the 

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

11 (1) in paragraph (1), in the matter before sub12 paragraph (A), by striking ‘‘paragraph (2)’’ and in13 serting ‘‘paragraphs (2) and (3)’’; and 

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

15 ‘‘(3) ANNUAL REPORTING REQUIRED.— 

16 ‘‘(A) REDUCTION IN PAYMENT FOR FAILURE

17 TO REPORT.— 

18 ‘‘(i) IN GENERAL.—The amount pay19 able under this section to a children’s hos20 pital for a fiscal year (beginning with fiscal 

21 year 2008 and after taking into account 

22 paragraph (2)) shall be reduced by 25 per23 cent if the Secretary determines that— 

24 ‘‘(I) the hospital has failed to pro25 vide the Secretary, as an addendum to 


ccoleman on PROD1PC71 with BILLS
4 

•HR 5574 RH

1 the hospital’s application under this 

2 section for such fiscal year, the report 

3 required under subparagraph (B) for 

4 the previous fiscal year; 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 to 

17 provide the required information within a 

18 period of 30 days beginning on the date of 

19 such notice. If the hospital provides such in20 formation within such period, no reduction 

21 shall be made under clause (i) on the basis 

22 of the previous failure to provide such infor23 mation. 

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


ccoleman on PROD1PC71 with BILLS
5 

•HR 5574 RH

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 resi4 dency academic year completed immediately 

5 prior to such fiscal year: 

6 ‘‘(i) The types of resident training pro7 grams that the hospital provided for resi8 dents described in subparagraph (C), such 

9 as general pediatrics, internal medicine/pe10 diatrics, and pediatric subspecialties, in11 cluding both medical subspecialties certified 

12 by the American Board of Pediatrics (such 

13 as pediatric gastroenterology) and non-med14 ical subspecialties approved by other med15 ical certification boards (such as pediatric 

16 surgery). 

17 ‘‘(ii) The number of training positions 

18 for residents described in subparagraph (C), 

19 the number of such positions recruited to 

20 fill, and the number of such positions filled. 

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

22 hospital provided for residents described in 

23 subparagraph (C) related to the health care 

24 needs of different populations, such as chil25 dren who are underserved for reasons of 


ccoleman on PROD1PC71 with BILLS
6 

•HR 5574 RH

1 family income or geographic location, in2 cluding rural and urban areas. 

3 ‘‘(iv) The changes in residency train4 ing for residents described in subparagraph 

5 (C) which the hospital has made during 

6 such residency academic year (except that 

7 the first report submitted by the hospital 

8 under this subparagraph shall be for such 

9 changes since the first year in which the 

10 hospital received payment under this sec11 tion), including— 

12 ‘‘(I) changes in curricula, train13 ing experiences, and types of training 

14 programs, and benefits that have re15 sulted from such changes; and 

16 ‘‘(II) changes for purposes of 

17 training the residents in the measure18 ment and improvement of the quality 

19 and safety of patient care. 

20 ‘‘(v) The numbers of residents described 

21 in subparagraph (C) who completed their 

22 residency training at the end of such resi23 dency academic year and care for children 

24 within the borders of the service area of the 

25 hospital or within the borders of the State 


ccoleman on PROD1PC71 with BILLS
7 

•HR 5574 RH

1 in which the hospital is located. Such num2 bers shall be disaggregated with respect to 

3 residents who completed residencies in gen4 eral pediatrics or internal medicine/pediat5 rics, subspecialty residencies, and dental 

6 residencies. 

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

8 in this subparagraph are those who— 

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

10 training positions in any training program 

11 sponsored by the hospital; or 

12 ‘‘(ii) are in a training program spon13 sored by an entity other than the hospital, 

14 but who spend more than 75 percent of 

15 their training time at the hospital. 

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

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

18 acting through the Administrator of the Health 

19 Resources and Services Administration, shall 

20 submit a report to the Congress— 

21 ‘‘(i) summarizing the information sub22 mitted in reports to the Secretary under 

23 subparagraph (B); 

24 ‘‘(ii) describing the results of the pro25 gram carried out under this section; and 


ccoleman on PROD1PC71 with BILLS
8 

•HR 5574 RH

1 ‘‘(iii) making recommendations for im2 provements to the program.’’. 

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

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

5 amended— 

6 (1) in subsection (c)(2)(E)(ii), by striking ‘‘de7 scribed in subparagraph (C)(ii)’’ and inserting ‘‘ap8 plied under section 1886(d)(3)(E) of the Social Secu9 rity Act for discharges occurring during the preceding 

10 fiscal year’’; 

11 (2) in subsection (e)(2), by striking the first sen12 tence; and 

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

14 pay’’ and inserting ‘‘made and pay’’. 


ccoleman on PROD1PC71 with BILLS

ccoleman on PROD1PC71 with BILLS
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 reauprograms in children’s hospitals. thorize support for graduate medical education 

JUNE 20, 2006 

Reported with an amendment, committed to the Comand ordered to be printed mittee of the Whole House on the State of the Union, 


ccoleman on PROD1PC71 with BILLS