I 

109TH CONGRESS 

1ST SESSION H. R. 1246 

To reauthorize the Children’s Hospitals Graduate Medical Education 

Program. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 10, 2005 

Mrs. JOHNSON of Connecticut (for herself, Ms. PRYCE of Ohio, Mr. BROWN

of Ohio, Mr. BACHUS, Ms. BALDWIN, Mrs. BONO, Ms. ESHOO, Mr. 

HALL, Mr. HULSHOF, Mr. RUSH, Mr. SESSIONS, Mr. SHAYS, Mr. 

SHIMKUS, Mr. SIMMONS, Ms. SOLIS, and Mr. WAXMAN) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To reauthorize the Children’s Hospitals Graduate Medical 

Education Program. 

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 Hospitals 

5 Education Equity and Research (CHEER) Act of 2005’’. 
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1 SEC. 2. REAUTHORIZATION OF CHILDREN’S HOSPITALS 

2 GRADUATE MEDICAL EDUCATION PROGRAM. 

3 (a) EXTENSION OF PROGRAM.—Section 340E(a) of 

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

5 amended by striking ‘‘2005’’ and inserting ‘‘2010’’. 

6 (b) DIRECT GRADUATE MEDICAL EDUCATION.—Sec7 tion 340E(c) of the Public Health Service Act (42 U.S.C. 

8 256e(c)) is amended— 

9 (1) in paragraph (1)(B), by inserting ‘‘but with10 out giving effect to section 1886(h)(7) of such Act)’’ 

11 after ‘‘section 1886(h)(4) of the Social Security 

12 Act’’; and 

13 (2) in paragraph (2)(E)(ii), by striking ‘‘de14 scribed in subparagraph (C)(ii)’’ and inserting ‘‘ap15 plied under section 1886(d)(3)(E) of the Social Se16 curity Act for discharges occurring during the pre17 ceding fiscal year’’. 

18 (c) NATURE OF PAYMENTS.—Section 340E(e)(3) of 

19 the Public Health Service Act (42 U.S.C. 256e(e)(3)) is 

20 amended by striking ‘‘made to pay’’ and inserting ‘‘made 

21 and pay’’. 

22 (d) AUTHORIZATION OF APPROPRIATIONS.—Section 

23 340E(f) of the Public Health Service Act (42 U.S.C. 

24 256e(f)) is amended— 

25 (1) in paragraph (1)(A)— 

26 (A) in clause (ii), by striking ‘‘and’’; 
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1 (B) in clause (iii), by striking the period 

2 and inserting a semicolon; and 

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

4 ‘‘(iv) for fiscal year 2006, 

5 $110,000,000; and 

6 ‘‘(v) for each of fiscal years 2007 

7 through 2010, such sums as may be nec8 essary.’’; and 

9 (2) in paragraph (2)— 

10 (A) in the matter preceding subparagraph 

11 (A)— 

12 (i) by striking ‘‘There are hereby au13 thorized’’ and inserting ‘‘There are author14 ized’’; and 

15 (ii) by striking ‘‘(b)(1)(A)’’ and in16 serting ‘‘(b)(1)(B)’’; 

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

18 ‘‘and’’; 

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

20 period and inserting a semicolon; and 

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

22 ‘‘(D) for fiscal year 2006, $220,000,000; 

23 and 

24 ‘‘(E) for each of fiscal years 2007 through 

25 2010, such sums as may be necessary.’’. 
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1 (e) TECHNICAL AMENDMENT.—Section 340E(e)(2) 

2 of the Public Health Service Act (42 U.S.C. 256e(e)(2)) 

3 is amended by striking the first sentence. 

4 (f) EXTENDING AVAILABILITY OF FUNDS THROUGH

5 THE FOLLOWING FISCAL YEAR.— 

6 (1) IN GENERAL.—Section 340E(f) of the Pub7 lic Health Service Act (42 U.S.C. 256e(f)) is amend8 ed— 

9 (A) in paragraph (1)(B)— 

10 (i) by inserting ‘‘or for fiscal year 

11 2006 (or any succeeding fiscal year)’’ after 

12 ‘‘for fiscal year 2000’’; and 

13 (ii) by striking ‘‘fiscal year 2001’’ and 

14 inserting ‘‘the end of the succeeding fiscal 

15 year’’; and 

16 (B) by adding at the end of paragraph (2) 

17 the following: 

18 ‘‘The amounts appropriated under this paragraph 

19 for a fiscal year (beginning with fiscal year 2006) 

20 shall remain available for obligation through the end 

21 of the succeeding fiscal year.’’. 

22 (2) CONFORMING AMENDMENT.—Section 

23 340E(b)(2)(A) of the Public Health Service Act (42 

24 U.S.C. 256e(b)(2)(A)) is amended by inserting be25 fore the period at the end the following: ‘‘plus the 
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1 funds remaining available from the previous fiscal 

2 year under paragraph (1)(B) or the second sentence 

3 of paragraph (2), respectively, of such subsection’’. 

4 (g) REDISTRIBUTION OF RECOUPED AMOUNTS.— 

5 Section 340E(e)(3) of the Public Health Service Act (42 

6 U.S.C. 256e(e)(3)) is amended by striking ‘‘to the extent 

7 possible.’’ and inserting a period and the following: ‘‘To 

8 the greatest extent possible, amounts recouped from a hos9 pital are to be distributed to other hospitals in the same 

10 fiscal year. Unless there is fraud, amounts paid to a hos11 pital without a demand for recoupment by the end of the 

12 fiscal year shall be final and not subject to recoupment.’’. 

13 (h) APPEALS PROCEDURES.—Section 340E(e) of the 

14 Public Health Service Act (42 U.S.C. 256e(e)) is amend15 ed— 

16 (1) in paragraph (3), by striking the last sen17 tence; and 

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

19 ‘‘(4) APPEALS.— 

20 ‘‘(A) IN GENERAL.—A decision affecting 

21 the amount payable to a hospital pursuant to 

22 this section shall— 

23 ‘‘(i) be subject to review under section 

24 1878 of the Social Security Act in the 

25 same manner as final determinations of 
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1 the amount of payment under section 

2 1886(d) of such Act are subject to review; 

3 and 

4 ‘‘(ii) be handled expeditiously so that 

5 the review decision is reflected in the final 

6 reconciliation for the year in which the ap7 peal is made. 

8 ‘‘(B) LIMITATION.—A review decision pur9 suant to this paragraph shall not affect pay10 ments for a fiscal year prior to the fiscal year 

11 in which the review decision is rendered. 

12 ‘‘(C) APPLICATION TO SUBSEQUENT FIS13 CAL YEARS.—The Secretary shall apply a re14 view decision under this paragraph in deter15 mining the amount of payment for the appeal16 ing hospital in the fiscal year in which the deci17 sion is rendered and in subsequent fiscal years, 

18 unless the law at issue in the review decision is 

19 amended or there are material differences be20 tween the facts for the fiscal year for which the 

21 review decision is rendered and the fiscal year 

22 for which payment is made. Nothing in this sec23 tion shall be construed to prohibit a hospital 
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1 from seeking review of similar determinations in 

2 subsequent fiscal years.’’. 

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