Training Psychiatrists for the Future Act

To amend title XVIII of the Social Security Act to provide for the distribution of additional residency positions in psychiatry and subspecialties. 1. Short title This Act may be cited as the Training Psychiatrists for the Future Act 2. Distribution of additional residency positions in psychiatry and psychiatry subspecialties (a) In general Section 1886(h) of the Social Security Act ( 42 U.S.C. 1395ww(h) (1) in paragraph (4)(F)(i), by striking and (9) (9), and (10) (2) in paragraph (4)(H)(i), by striking and (9) (9), and (10) (3) by adding at the end the following new paragraph: (10) Distribution of additional residency positions in psychiatry and psychiatry subspecialties (A) Additional residency positions (i) In general For fiscal year 2025, and for each succeeding fiscal year until the aggregate number of full-time equivalent residency positions distributed under this paragraph is equal to the aggregate number of such positions made available (as specified in clause (ii)(I)), the Secretary shall, subject to the succeeding provisions of this paragraph, increase the otherwise applicable resident limit for each qualifying hospital (as defined in subparagraph (F)) that submits a timely application under this subparagraph by such number as the Secretary may approve effective beginning July 1 of the fiscal year of the increase. (ii) Number available for distribution (I) Total number available The aggregate number of such positions made available under this paragraph shall be equal to 400. (II) Annual limit The aggregate number of such positions so made available shall not exceed 200 for a fiscal year. (iii) Distribution for psychiatry or psychiatry subspecialty residencies Each of the positions made available under this paragraph shall be in a psychiatry or psychiatry subspecialty residency (as defined in subparagraph (F)). (iv) Process for distributing positions (I) Rounds of applications The Secretary shall initiate a separate round of applications for an increase under clause (i) for each fiscal year for which such an increase is to be provided. (II) Timing The Secretary shall notify hospitals of the number of positions distributed to the hospital under this paragraph as a result of an increase in the otherwise applicable resident limit by January 31 of the fiscal year of the increase. Such increase shall be effective beginning July 1 of such fiscal year. (B) Distribution For purposes of providing an increase in the otherwise applicable resident limit under subparagraph (A), the following shall apply: (i) Considerations in distribution In determining for which qualifying hospitals such an increase is provided under subparagraph (A), the Secretary shall take into account the demonstrated likelihood of the hospital filling the positions made available under this paragraph within the first 5 training years beginning after the date the increase would be effective, as determined by the Secretary. (ii) Distribution for certain categories of hospitals With respect to the aggregate number of such positions available for distribution under this paragraph, the Secretary shall distribute such aggregate number to the following categories of hospitals: (I) To hospitals that are located in a rural area (as defined in section 1886(d)(2)(D)) or are treated as being located in a rural area pursuant to section 1886(d)(8)(E). (II) To hospitals in which the reference resident level of the hospital (as specified in subparagraph (F)(iv)) is greater than the otherwise applicable resident limit. (III) To hospitals in States with— (aa) new medical schools that received Candidate School Pre-Accreditation Full Accreditation Accreditation (bb) additional locations and branch campuses established on or after January 1, 2000, by medical schools with Full Accreditation Accreditation (IV) To hospitals that serve areas designated as health professional shortage areas under section 332(a)(1)(A) of the Public Health Service Act, as determined by the Secretary. (V) To hospitals located in States with less than 27 residents per 100,000 people. (C) Requirements (i) In general Subject to clause (ii), a hospital that receives an increase in the otherwise applicable resident limit under this paragraph shall ensure, during the 5-year period beginning on the date of such increase, that— (I) the number of full-time equivalent residents in a psychiatry or psychiatry subspecialty residency (as defined in subparagraph (F)), excluding any additional positions attributable to an increase under this paragraph, is not less than the average number of full-time equivalent residents in such a residency during the 3 most recent cost reporting periods ending prior to the date of enactment of this paragraph; and (II) all of the positions attributable to such increase are in a psychiatry or psychiatry subspecialty residency (as determined by the Secretary). The Secretary may determine whether a hospital has met the requirements under this clause during such 5-year period in such manner and at such time as the Secretary determines appropriate, including at the end of such 5-year period. (ii) Redistribution of positions if hospital no longer meets certain requirements In the case where the Secretary determines that a hospital described in clause (i) does not meet either of the requirements under subclause (I) or (II) of such clause, the Secretary shall— (I) reduce the otherwise applicable resident limit of the hospital by the amount by which such limit was increased under this paragraph; and (II) provide for the distribution of positions attributable to such reduction in accordance with the requirements of this paragraph. (iii) Limitation A hospital may not receive more than 10 additional full-time equivalent residency positions under this paragraph. (iv) Prohibition on distribution to hospitals without an increase agreement No increase in the otherwise applicable resident limit of a hospital may be made under this paragraph unless such hospital agrees to increase the total number of full-time equivalent residency positions under the approved medical residency training program of such hospital by the number of such positions made available by such increase under this paragraph. (D) Application of per resident amounts for nonprimary care With respect to additional residency positions in a hospital attributable to the increase provided under this paragraph, the approved FTE per resident amounts are deemed to be equal to the hospital per resident amounts for nonprimary care computed under paragraph (2)(D) for that hospital. (E) Permitting facilities to apply aggregation rules The Secretary shall permit hospitals receiving additional residency positions attributable to the increase provided under this paragraph to, beginning in the fifth year after the effective date of such increase, apply such positions to the limitation amount under paragraph (4)(F) that may be aggregated pursuant to paragraph (4)(H) among members of the same affiliated group. (F) Definitions In this paragraph: (i) Otherwise applicable resident limit The term otherwise applicable resident limit (ii) Psychiatry or psychiatry subspecialty residency The term psychiatry or psychiatry subspecialty residency (iii) Qualifying hospital The term qualifying hospital (iv) Reference resident level The term reference resident level (v) Resident level The term resident level . (b) IME Section 1886(d)(5)(B) of the Social Security Act ( 42 U.S.C. 1395ww(d)(5)(B) (1) in clause (v), in the third sentence, by striking and (h)(9) (h)(9), and (h)(10) (2) by moving clause (xii) 4 ems to the left; and (3) by adding at the end the following new clause: (xiii) For discharges occurring on or after July 1, 2024, insofar as an additional payment amount under this subparagraph is attributable to resident positions distributed to a hospital under subsection (h)(10), the indirect teaching adjustment factor shall be computed in the same manner as provided under clause (ii) with respect to such resident positions. . (c) Prohibition on judicial review Section 1886(h)(7)(E) of the Social Security Act (42 U.S.C. 1395ww—4(h)(7)(E)) is amended by inserting paragraph (10), paragraph (8),

Summary: Training Psychiatrists for the Future Act This bill provides for additional psychiatry residency positions for purposes of graduate medical education payments under Medicare.