‘‘(j)(1)(A) In order that the working conditions and 
working hours of physicians and postgraduate trainees 
promote the provision of quality medical care in hospitals, 
as a condition of participation under this title each hos-
pital shall establish the following limits on working hours 
for certain members of the medical staff and postgraduate 
trainees: 
‘‘(i) Subject to subparagraph (C), postgraduate 
trainees may work no more than a total of 80 hours 
per week and 24 hours per shift. 
‘‘(ii) Subject to subparagraph (C), postgraduate 
trainees—
‘‘(I) shall have at least 10 hours between 
scheduled shifts; 
‘‘(II) shall have at least 1 full day out of 
every 7 days off and one full weekend off per 
month; 
‘‘(III) who are assigned to patient care re-
sponsibilities in an emergency department shall 
work no more than 12 continuous hours in that 
department; and 
‘‘(IV) shall not be scheduled to be on call 
in the hospital more often than every third 
night.
‘‘(B) The Secretary shall promulgate such regulations 
as may be necessary to ensure quality of care is main-
tained during the transfer of direct patient care from one 
postgraduate trainee to another at the end of each such 
24 hour period referred to in subparagraph (A) and shall 
take into account cases of individual patient emergencies. 
‘‘(C) The work hour limitations under subparagraph 
(A) and requirements of subparagraph (B) shall not apply 
to a hospital during a state of emergency declared by the 
Secretary that applies with respect to that hospital. 
‘‘(2) The Secretary shall promulgate such regulations 
as may be necessary to monitor and supervise post-
graduate trainees assigned patient care responsibilities as 
part of an approved medical training program, as well as 
to assure quality patient care. 
‘‘(3) Each hospital shall inform postgraduate trainees 
of—
‘‘(A) their rights under this subsection, includ-
ing methods to enforce such rights (including so-
called whistle-blower protections); and 
‘‘(B) the effects of their acute and chronic sleep 
deprivation both on themselves and on their pa-
tients.
‘‘(4) For purposes of this subsection, the term ‘post-
graduate trainee’ includes a postgraduate intern, resident, 
or fellow.’’. 
(b) DESIGNATION.—
(1) IN GENERAL.—The Secretary of Health and 
Human Services shall designate an individual within 
the Department of Health and Human Services to 
handle all complaints of violations that arise from 
residents who report that their programs are in vio-
lation of the requirements of section 1866(j) of the 
Social Security Act (as added by subsection (a)). 
(2) GRIEVANCE
RIGHTS.—A post graduate 
trainee or physician resident may file a complaint 
with the Secretary of Health and Human Services 
concerning a violation of such requirements. Such a 
complaint may be filed anonymously. The Secretary 
may conduct an investigation and take such correc-
tive action with respect to such a violation. 
(3) CIVIL MONEY PENALTY ENFORCEMENT.—
Any hospital that violates such requirement is sub-
ject to a civil money penalty not to exceed $100,000 
for each resident training program in any 6-month 
period. The provisions of section 1128A of the Social 
Security Act (other than subsections (a) and (b)) 
shall apply to civil money penalties under this para-
graph in the same manner as they apply to a pen-
alty or proceeding under section 1128A(a) of such 
Act. 
(4) DISCLOSURE OF VIOLATIONS AND ANNUAL 
REPORTS.—The individual designated under para-
graph (1) shall—
(A) provide for annual anonymous surveys 
of postgraduate trainees to determine compli-
ance with such requirements and for the disclo-
sure of the results of such surveys to the public 
on a residency-program specific basis; 
(B) based on such surveys, conduct appro-
priate on-site investigations; 
(C) provide for disclosure to the public of 
violations and compliance, on a hospital and 
residence-program specific basis, of such re-
quirements; and 
(D) make an annual report to Congress on 
the compliance of hospitals with such require-
ments, including providing a list of hospitals 
found to be in violation of such requirements. 
(c) WHISTLEBLOWER PROTECTIONS.—
(1) IN GENERAL.—A hospital covered by the re-
quirements of section 1866(j)(1) of the Social Secu-
rity Act (as inserted by subsection (a)) shall not pe-
nalize, discriminate, or retaliate in any manner 
against an employee with respect to compensation, 
terms, conditions or privileges of employment, who 
in good faith (as defined in paragraph (2)), individ-
ually or in conjunction with another person or per-
sons—
(A) reports a violation or suspected viola-
tion of such requirements to a public regulatory 
agency, a private accreditation body, or man-
agement personnel of the hospital; 
(B) initiates, cooperates or otherwise par-
ticipates in an investigation or proceeding 
brought by a regulatory agency or private ac-
creditation body concerning matters covered by 
such requirements; 
(C) informs or discusses with other em-
ployees, with a representative of the employees, 
with patients or patient representatives, or with 
the public, violations or suspected violations of 
such requirements; or 
(D) otherwise avails himself or herself of 
the rights set forth in such section or this sub-
section.