II 

116TH CONGRESS 

1ST SESSION S. 1191 

To reauthorize section 340H of the Public Health Service Act to continue 

to encourage the expansion, maintenance, and establishment of approved 

graduate medical residency programs at qualified teaching health centers, 

and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

APRIL 11, 2019 

Ms. COLLINS (for herself, Mr. TESTER, Mrs. CAPITO, Mr. JONES, Mr. BOOZMAN, Mr. MANCHIN, Mr. DAINES, and Ms. HARRIS) introduced the following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

A BILL 

To reauthorize section 340H of the Public Health Service 

Act to continue to encourage the expansion, maintenance, 

and establishment of approved graduate medical residency programs at qualified teaching health centers, and 

for other purposes. 

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 ‘‘Training the Next 

5 Generation of Primary Care Doctors Act of 2019’’. 


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1 SEC. 2. FINDINGS. 

2 Congress finds as follows: 

3 (1) The program of payments to teaching 

4 health centers for graduate medical education under 

5 section 340H of the Public Health Service Act (42 

6 U.S.C. 256h) was enacted in 2010 and reauthorized 

7 in 2015 and 2018 to address the crisis-level shortage 

8 of primary care physicians, especially in rural and 

9 medically underserved communities. 

10 (2) Teaching health center residents and faculty 

11 will provide more than 1,000,000 primary care med12 ical visits in 2019 to underserved communities. 

13 (3) When compared with traditional Medicare 

14 GME residents, residents who train at teaching 

15 health centers are more likely to practice primary 

16 care and remain in underserved or rural commu17 nities. 

18 (4) The teaching health center program not 

19 only plays a vital role in training the Nation’s next 

20 generation of primary care physicians (including 

21 dentists), but helps bridge the Nation’s physician 

22 shortfall and address the maldistribution of physi23 cians across the United States. 

24 (5) For these reasons, it is of vital importance 

25 to continue the program under section 340H of the 

26 Public Health Service Act (42 U.S.C. 256h) at a 


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1 sustainable level of funding per full-time equivalent 

2 resident, as recommended in the fact sheet of the 

3 Health Resources and Services Administration enti4 tled ‘‘Cost Estimates for Training Residents in a 

5 Teaching Health Center’’. 

6 SEC. 3. PAYMENTS. 

7 (a) IN GENERAL.—Subsection (g) of section 340H of 

8 the Public Health Service Act (42 U.S.C. 256h(g)) is 

9 amended— 

10 (1) by redesignating paragraph (2) as para11 graph (4); and 

12 (2) by inserting after paragraph (1) the fol13 lowing: 

14 ‘‘(2) PAYMENTS TO APPROVED GRADUATE MED15 ICAL RESIDENCY TRAINING PROGRAMS.—To carry 

16 out this section, for payments to approved graduate 

17 medical residency programs (as defined in paragraph 

18 (j)(1) of this section), there are appropriated 

19 $126,500,000 for fiscal year 2020, $128,000,000 for 

20 fiscal year 2021, $129,500,000 for fiscal year 2022, 

21 $131,000,000 for fiscal year 2023, and 

22 $132,500,000 for fiscal year 2024, to remain avail23 able until expended. 

24 ‘‘(3) PAYMENTS TO NEW APPROVED GRADUATE

25 MEDICAL RESIDENCY TRAINING PROGRAMS.—To 


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1 carry out this section, for payments to new approved 

2 graduate medical residency training programs (as 

3 defined in paragraph (j)(2) of this section), there are 

4 appropriated $6,000,000 for fiscal year 2021, 

5 $12,000,000 for fiscal year 2022, $17,000,000 for 

6 fiscal year 2023, and $25,000,000 for fiscal year 

7 2024, to remain available until expended.’’. 

8 (b) NUMBER OF RESIDENTS.—In calculating the 

9 level of payments to each approved graduate medical resi10 dency training program pursuant to paragraph (g)(2) of 

11 section 340H of the Public Health Service Act (42 U.S.C. 

12 256h), the Secretary of Health and Human Services shall 

13 pay for the number of residents at a program at a number 

14 that is no lower than the highest number of residents in 

15 their programs for the period of fiscal years 2016 through 

16 2018. 

17 (c) LIMITATIONS.—The number of full-time equiva18 lent residents for which a qualified teaching health center 

19 receives payments pursuant to subparagraph (a)(1)(C) of 

20 section 340H of the Public Health Service Act (42 U.S.C. 

21 256h) for a fiscal year shall not exceed by more than 6 

22 the number of full-time equivalent residents for which the 

23 center received such payments for the preceding fiscal 

24 year. 


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1 (d) REPORT ON EXPANSION.—Not later than Sep2 tember 30, 2021, the Secretary of Health and Human 

3 Services shall submit to the Congress a report on the es4 tablishment of new approved graduate medical residency 

5 programs and expansion of existing approved graduate 

6 medical residency programs. The report shall include the 

7 locations of such programs, the number of residents, and 

8 statistics regarding the number of programs receiving pri9 ority under paragraph (a)(3) of section 340H of the Pub10 lic Health Service Act (42 U.S.C. 256h). 

11 (e) PUBLIC AVAILABILITY OF DATA.—The Secretary 

12 of Health and Human Services shall make available to the 

13 public the data reported by qualified teaching health cen14 ters pursuant to subsection (d) of this section and para15 graph (h)(1) of section 340H of the Public Health Service 

16 Act (42 U.S.C. 256(h)). 

Æ 


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