I

106TH CONGRESS

1ST SESSION H. R. 1222

To amend title XVIII of the Social Security Act to make certain changes

related to payments for graduate medical education under the Medicare

Program.

IN THE HOUSE OF REPRESENTATIVES

MARCH 23, 1999

Mr. BALDACCI (for himself, Mr. KLECZKA, and Mr. SANDERS) introduced the

following bill; which was referred to the Committee on Ways and Means,

and in addition to the Committee on Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such

provisions as fall within the jurisdiction of the committee concerned

A BILL

To amend title XVIII of the Social Security Act to make

certain changes related to payments for graduate medical

education under the Medicare 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 ‘‘Graduate Medical Edu5 cation Technical Amendments of 1999’’.
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1 SEC. 2. INDIRECT GRADUATE MEDICAL EDUCATION AD2 JUSTMENT.

3 (a) IN GENERAL.—Section 1886(d)(5)(B)(v) of the

4 Social Security Act (42 U.S.C. 1395ww(d)(5)(B)(v)) (as

5 added by section 4621(b) of the Balanced Budget Act of

6 1997) is amended—

7 (1) by striking ‘‘(v) In determining’’ and insert8 ing ‘‘(v)(I) Subject to subclause (II), in deter9 mining’’;

10 (2) by striking ‘‘in the hospital with respect to

11 the hospital’s most recent cost reporting period end12 ing on or before December 31, 1996’’; and inserting

13 ‘‘who were appointed by the hospital’s approved

14 medical residency training programs for the hos15 pital’s most recent cost reporting period ending on

16 or before December 31, 1996’’; and

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

18 ‘‘(II) Beginning on or after January 1, 1997, in the

19 case of a hospital that sponsors only 1 allopathic or osteo20 pathic residency program, the limit determined for such

21 hospital under subclause (I) may, at the hospital’s discre22 tion, be increased by 1 for each calendar year but shall

23 not exceed a total of 3 more than the limit determined

24 for the hospital under subclause (I).’’.

25 (b) TECHNICAL AMENDMENTS.—Section

26 1886(d)(5)(B) of the Social Security Act (42 U.S.C.
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1 1395ww(d)(5)(B)) is amended by moving clauses (ii), (v),

2 and (vi) 2 ems to the left.

3 SEC. 3. DIRECT GRADUATE MEDICAL EDUCATION ADJUST4 MENT.

5 (a) LIMITATION ON NUMBER OF RESIDENTS.—Sec6 tion 1886(h)(4)(F) of the Social Security Act (42 U.S.C.

7 1395ww(h)(4)(F)) (as added by section 4623 of the

8 Balanced Budget Act of 1997) is amended by inserting

9 ‘‘who were appointed by the hospital’s approved medical

10 residency training programs’’ after ‘‘may not exceed the

11 number of such full-time equivalent residents’’.

12 (b) FUNDING FOR NEW PROGRAMS.—The first sen13 tence of section 1886(h)(4)(H)(i) of the Social Security

14 Act (42 U.S.C. 1395ww(h)(4)(H)(i)) (as added by section

15 4623 of the Balanced Budget Act of 1997) is amended

16 by inserting ‘‘and before September 30, 1999’’ after ‘‘Jan17 uary 1, 1995’’.

18 (c) FUNDING FOR PROGRAMS MEETING RURAL

19 NEEDS.—The second sentence of section 1886(h)(4)(H)(i)

20 of the Social Security Act (42 U.S.C.

21 1395ww(h)(4)(H)(i)) (as added by section 4623 of the

22 Balanced Budget Act of 1997) is amended by striking the

23 period at the end and inserting ‘‘, including facilities that

24 are not located in an underserved rural area but have es25 tablished separately accredited rural training tracks.’’.
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1 SEC. 4. EFFECTIVE DATE.

2 The amendments made by this Act shall take effect

3 as if included in the enactment of the Balanced Budget

4 Act of 1997.

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