Physician Shortage GME Cap Flex Act of 2021

To provide for a new building period with respect to the cap on full-time equivalent residents for purposes of payment for graduate medical education costs under the Medicare program for certain hospitals that have established a shortage specialty program. 1. Short title This Act may be cited as the Physician Shortage GME Cap Flex Act of 2021 2. Providing for a new building period with respect to the cap on full-time equivalent residents for certain hospitals that have established a shortage specialty program Section 1886(h)(4) of the Social Security Act ( 42 U.S.C. 1395ww(h)(4) (L) Treatment of certain qualifying hospitals (i) In general For purposes of applying this paragraph and section 413.79 of title 42, Code of Federal Regulations (or a successor regulation), the Secretary shall treat, subject to clause (ii), a qualifying hospital (as defined in clause (iii)) with an approved medical residency training program as if such hospital— (I) had no allopathic or osteopathic residents in its most recent cost reporting period ending on or before December 31, 1996; and (II) began training residents for the first time in a new medical residency training program (as defined in paragraph (l) of such section) beginning on the date on which such hospital became a qualifying hospital. (ii) Special rule for qualifying hospitals in cap-building period In the case of a qualifying hospital with an approved medical residency training program that, excluding the treatment described in clause (i), is a hospital that had no allopathic or osteopathic residents in its most recent cost reporting period ending on or before December 31, 1996, and began training residents for the first time in a new medical residency training program (as defined in paragraph (l) of such section) during the 5-year period ending on the date described in clause (i)(II) with respect to such hospital, in lieu of applying such clause, the Secretary shall provide that the provisions of subsection (e) of section 413.79 of title 42, Code of Federal Regulations (or a successor regulation), shall apply with respect to such hospital for an additional 5 years beyond the period during which such provisions would otherwise have applied to such hospital. (iii) Definition In this subparagraph: (I) Qualifying hospital The term qualifying hospital (aa) establishes a shortage specialty program (as defined in subclause (II)) during the 5-year period beginning on the date of the enactment of this subparagraph; and (bb) submits an application to the Secretary during such period containing such information as the Secretary may specify. (II) Shortage specialty program The term shortage specialty program (aa) without adequate health care resources (such as in a rural area or a medically underserved area (as defined by the Administrator of the Health Resources and Services Administration)); (bb) experiencing primary care or specialty physician shortages (such as in a health professional shortage area (as defined in section 332(a) of the Public Health Service Act ( 42 U.S.C. 254e(a) (cc) without an adequate number of approved residency training programs; (dd) struggling to expand or keep approved residency training programs operational; (ee) lacking existing medical training infrastructure or in the process of building such infrastructure; (ff) with a low resident-to-population ratio; (gg) with few full-time equivalent resident positions; or (hh) with a low physician-to-population ratio for physicians practicing in the same specialty as the shortage specialty program concerned. .

Summary: Physician Shortage GME Cap Flex Act of 2021 This bill excludes certain hospitals that establish shortage specialty programs from the cap on full-time equivalent residents that is otherwise applicable, and provides for a new building period, for purposes of graduate medical education payments under Medicare.