I 

113TH CONGRESS 

2D SESSION H. R. 4282 

To amend the Public Health Service Act to authorize grants for graduate 

medical education partnerships in States with a low ratio of medical 

residents relative to the general population. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 21, 2014 

Ms. CASTOR of Florida (for herself and Mr. HECK of Nevada) introduced the 

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

A BILL 

To amend the Public Health Service Act to authorize grants 

for graduate medical education partnerships in States 

with a low ratio of medical residents relative to the 

general population. 

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 ‘‘Creating Access to 

5 Residency Education Act of 2014’’. 


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1 SEC. 2. GRADUATE MEDICAL EDUCATION PARTNERSHIPS 

2 IN STATES WITH A LOW RATIO OF MEDICAL 

3 RESIDENTS RELATIVE TO GENERAL POPU4 LATION. 

5 Part B of title III of the Public Health Service Act 

6 is amended by inserting after section 317T (42 U.S.C. 

7 247b–22) the following: 

8 ‘‘SEC. 317U. GRADUATE MEDICAL EDUCATION PARTNER9 SHIPS IN STATES WITH A LOW RATIO OF MED10 ICAL RESIDENTS RELATIVE TO GENERAL 

11 POPULATION. 

12 ‘‘(a) IN GENERAL.—The Administrator of the Cen13 ters for Medicare & Medicaid Services (in this section re14 ferred to as the ‘Administrator’) shall make grants to, or 

15 enter into contracts with, eligible entities to support the 

16 creation of new medical residency training programs or 

17 slots within existing programs in States in which there is 

18 a low ratio of medical residents relative to the general pop19 ulation. 

20 ‘‘(b) ELIGIBILITY.—To be eligible to receive Federal 

21 funding under this section, an entity must— 

22 ‘‘(1) be located in a State in which there are 

23 fewer than 25 medical residents per population of 

24 100,000; and 


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1 ‘‘(2) be a public or nonprofit teaching hospital 

2 or an accredited graduate medical education training 

3 program. 

4 ‘‘(c) PARTNERSHIPS.—In supporting the creation of 

5 new medical residency training programs or slots through 

6 a grant or contract under this section, an eligible entity 

7 may enter into a partnership with a State, local govern8 ment, community health center, local health department, 

9 hospital, or other organization deemed by the entity to be 

10 appropriate. 

11 ‘‘(d) MATCHING FUNDS.—An agreement awarding a 

12 grant or contract under this section shall— 

13 ‘‘(1) in the case of a new or existing medical 

14 residency training program in the field of primary 

15 care— 

16 ‘‘(A) require the entity awarded such grant 

17 or contract to provide one-third of the cost of 

18 the slots to be funded through the agreement; 

19 and 

20 ‘‘(B) to the extent and in the amounts 

21 made available in advance in appropriations 

22 Acts, require the Administrator to provide the 

23 remaining two-thirds of the cost of such slots; 

24 and 


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1 ‘‘(2) in the case of a new or existing medical 

2 residency training program in any other field— 

3 ‘‘(A) require the award recipient to provide 

4 one-half of the cost of the slots to be funded 

5 through the agreement; and 

6 ‘‘(B) to the extent and in the amounts 

7 made available in advance in appropriations 

8 Acts, require the Administrator to provide the 

9 remaining one-half of the cost of such slots. 

10 ‘‘(e) REQUIREMENTS.—The Administrator shall es11 tablish application processes for eligible entities to receive 

12 funding under this section, including multiyear commit13 ments to ensure the continued funding of graduate med14 ical education slots for residents in training. 

15 ‘‘(f) DEFINITION.—For purposes of this section, the 

16 Administrator shall define the term ‘primary care’. 

17 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—To 

18 carry out this section, there are authorized to be appro19 priated $25,000,000 for fiscal year 2015, and such sums 

20 as may be necessary for fiscal years 2016 through 2020.’’. 

Æ 


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