I 
116TH CONGRESS 
1ST SESSION H. R. 2815 
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 HOUSE OF REPRESENTATIVES 
MAY 16, 2019 
Mr. RUIZ (for himself, Mrs. RODGERS of Washington, Ms. TORRES SMALL of 
New Mexico, and Mr. DAVID P. ROE of Tennessee) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce 
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 resi-
dency programs at qualified teaching health centers, and 
for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Training the Next 
Generation of Primary Care Doctors Act of 2019’’. 
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SEC. 2. FINDINGS. 
Congress finds as follows: 
(1) The program of payments to teaching 
health centers for graduate medical education under 
section 340H of the Public Health Service Act (42 
U.S.C. 256h) was enacted in 2010 and reauthorized 
in 2015 and 2018 to address the crisis-level shortage 
of primary care physicians, especially in rural and 
medically underserved communities. 
(2) Teaching health center residents and faculty 
will provide more than 1,000,000 primary care med-
ical visits in 2019 to underserved communities. 
(3) When compared with traditional Medicare 
GME residents, residents who train at teaching 
health centers are more likely to practice primary 
care and remain in underserved or rural commu-
nities. 
(4) The teaching health center program not 
only plays a vital role in training the Nation’s next 
generation of primary care physicians (including 
dentists), but helps bridge the Nation’s physician 
shortfall and address the maldistribution of physi-
cians across the United States. 
(5) For these reasons, it is of vital importance 
to continue the program under section 340H of the 
Public Health Service Act (42 U.S.C. 256h) at a 
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sustainable level of funding per full-time equivalent 
resident, as recommended in the fact sheet of the 
Health Resources and Services Administration enti-
tled ‘‘Cost Estimates for Training Residents in a 
Teaching Health Center’’. 
SEC. 3. PAYMENTS. 
(a) IN GENERAL.—Subsection (g) of section 340H of 
the Public Health Service Act (42 U.S.C. 256h(g)) is 
amended— 
(1) by redesignating paragraph (2) as para-
graph (4); and 
(2) by inserting after paragraph (1) the fol-
lowing: 
‘‘(2) PAYMENTS TO APPROVED GRADUATE MED-
ICAL
RESIDENCY
TRAINING
PROGRAMS.—To carry 
out this section, for payments to approved graduate 
medical residency programs (as defined in paragraph 
(j)(1) of this section), there are appropriated 
$126,500,000 for fiscal year 2020, $128,000,000 for 
fiscal year 2021, $130,000,000 for fiscal year 2022, 
$133,000,000 
for 
fiscal 
year 
2023, 
and 
$136,000,000 for fiscal year 2024, to remain avail-
able until expended. 
‘‘(3) PAYMENTS TO NEW APPROVED GRADUATE 
MEDICAL
RESIDENCY
TRAINING
PROGRAMS.—To 
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carry out this section, for payments to new approved 
graduate medical residency training programs (as 
defined in paragraph (j)(2) of this section), there are 
appropriated $8,500,000 for fiscal year 2021, 
$17,000,000 for fiscal year 2022, $34,500,000 for 
fiscal year 2023, and $44,000,000 for fiscal year 
2024, to remain available until expended.’’. 
(b) NUMBER
OF RESIDENTS.—In calculating the 
level of payments to each approved graduate medical resi-
dency training program pursuant to subsection (g)(2) of 
section 340H of the Public Health Service Act (42 U.S.C. 
256h), the Secretary of Health and Human Services shall 
pay for the number of residents at a program at a number 
that is no lower than the highest number of residents in 
their programs for the period of fiscal years 2016 through 
2018. 
(c) LIMITATIONS.—The number of full-time equiva-
lent residents for which a qualified teaching health center 
receives payments pursuant to subsection (a)(1)(C) of sec-
tion 340H of the Public Health Service Act (42 U.S.C. 
256h) for a fiscal year shall not exceed by more than 6 
the number of full-time equivalent residents for which the 
center received such payments for the preceding fiscal 
year. 
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