140 
such individual for previous periods through the 
end of such year. 
‘‘(3) COMPARISON.—An appropriate comparison 
of such contributions with such benefits. 
‘‘(c) RECORDS RETENTION.—The Medicare Choices 
Commission shall provide for the indefinite retention of 
information that— 
‘‘(1) is described in subsection (b), including 
benefits described in subsection (b)(2); and 
‘‘(2) the Medicare Choices Commission has not 
discarded as of the date of the enactment of this 
section. 
‘‘(d) ELIGIBLE INDIVIDUAL DEFINED.—In this sec-
tion, the term ‘eligible individual’ means an individual— 
‘‘(1) who has a social security account number; 
‘‘(2) who has attained age 25 or over; and 
‘‘(3) who is a Medicare enrollee (as defined in 
section 1860E–61(b)) or who, as of the end of the 
most recent year referred to in subsection (b)(1)(A), 
has had any contributions described in subsection 
(b)(1) made with respect to the individual during 
such year or a previous year.’’. 
(b) INCLUSION
OF
SOCIAL
SECURITY
ACCOUNT 
STATEMENT FOR THOSE RECEIVING ANNUAL MEDICARE 
INFORMATION STATEMENT.—Section 1143(a)(3) of such 
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Act (42 U.S.C. 1320b–13(a)(3)) is amended by adding at 
the end the following: 
‘‘Such term includes an individual not described in 
the previous sentence who is an eligible individual (as de-
fined in subsection (d) of section 1143A) for whom an an-
nual Medicare information statement is provided under 
such section.’’. 
Subtitle B—Miscellaneous 
SEC. 311. REPEAL OF IPAB. 
Effective as if included in the enactment of the Pa-
tient Protection and Affordable Care Act (Public Law 
111–148), the provisions of, and amendments made by, 
sections 3403 and 10320 of such Act (other than sub-
section (d) of section 1899A of the Social Security Act, 
as added and amended by such sections) are repealed. 
SEC. 312. REPEAL OF MEDICARE PAYMENT PRODUCTIVITY 
ADJUSTMENTS AFTER 2020. 
The provisions of, and amendments made by, section 
3401 of the Patient Protection and Affordable Care Act 
(Public Law 111–148), as amended by title X of such Act 
and section 1105 of the Health Care and Education Rec-
onciliation Act of 2010, insofar as such provisions (and 
amendments) relate to a productivity adjustment, shall 
not apply with respect to payments for items or services 
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142 
furnished during any year after fiscal year 2020 or cal-
endar year 2020, as applicable. 
SEC. 313. GRADUATE MEDICAL EDUCATION GRANT PRO-
GRAM. 
(a) IN GENERAL.—Title XVIII of the Social Security 
Act is amended by adding at the end the following new 
section: 
‘‘SEC. 1899B. GRADUATE MEDICAL EDUCATION GRANT PRO-
GRAM. 
‘‘(a) ESTABLISHMENT.—For cost reporting periods 
occurring during fiscal year 2015 or a subsequent fiscal 
year, the Secretary shall carry out a grant program under 
which the Secretary shall provide to each hospital with an 
approved medical residency training program a grant in 
accordance with the subsequent provisions of this section 
for costs of such hospital for indirect and direct graduate 
medical education. Such grants are instead of any pay-
ment under subsection (d)(5)(B) or (h) of section 1886, 
payments for direct or indirect medical education costs 
under title XIX, or section 340E of the Public Health 
Service Act for such costs during such fiscal year. 
‘‘(b) GRANT AMOUNT.—Subject to subsections (c) 
and (d), the amount of a grant to a hospital under sub-
section (a) for a cost reporting period occurring during 
a fiscal year shall be equal to— 
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‘‘(1) in the case of a subsection (d) hospital, the 
sum of— 
‘‘(A) the payment amount the hospital 
would have received under section 1886(h)(3), 
without application of this section or the last 
sentence of section 1886(h)(1), for such cost re-
porting period; and 
‘‘(B) 72 percent of the additional payment 
amount the hospital would have received under 
section 1886(d)(5)(B), without application of 
this section or clause (xii) of such section 
1886(d)(5)(B), for such cost reporting period; 
‘‘(2) in the case of a hospital in a State, an 
amount determined in accordance with a method-
ology specified by the Secretary, which shall be in 
lieu of any amount that the hospital otherwise 
would, without application of this section or section 
1903(i)(27), have received under the State plan 
under title XIX for expenses of such hospital attrib-
utable to the costs of direct and indirect graduate 
medical education; and 
‘‘(3) in the case of a children’s hospital (as de-
fined in subsection (g) of section 340E of the Public 
Health Service Act), the sum of— 
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‘‘(A) the amount that would be determined 
under subsection (c) of such section for such 
hospital for direct expenses associated with op-
erating approved graduate medical residency 
training programs for such period, without ap-
plication of this section or subsection (h) of 
such section 340E; and 
‘‘(B) the amount that would be determined 
under subsection (d) of such section for such 
hospital for indirect expenses associated with 
the treatment of more severely ill patients and 
the additional costs relating to teaching resi-
dents in such programs for such period, without 
application of this section or subsection (h) of 
such section 340E. 
‘‘(c) MODIFICATION.—Subject to subsection (d)(1), 
the Secretary may modify the grant amounts under sub-
section (b), including after application of subsection 
(d)(2), based on factors such as the number of residents 
of approved medical residency training programs, the ex-
tent to which such programs provide for primary care 
training, the curriculum of such programs, and the quality 
of care provided through such programs. 
‘‘(d) LIMITATION.— 
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‘‘(1) IN GENERAL.—In no case may the aggre-
gate amount of grants awarded under subsection (a) 
for a fiscal year exceed the amount made available 
under subsection (e)(1) for such fiscal year for car-
rying out this section. 
‘‘(2) PRO-RATION.—In the case of a fiscal year 
for which the aggregate amount of grants under this 
section is projected to exceed the amount made 
available under subsection (e)(1) for such fiscal year 
for carrying out this section, the Secretary shall re-
duce the amount of each grant awarded under this 
section for such fiscal year by a prorated amount. 
Subject to paragraph (1), the Secretary may modify 
such a prorated amount in accordance with sub-
section (c). 
‘‘(e) FUNDING.— 
‘‘(1) IN GENERAL.—For fiscal year 2015 and 
each subsequent fiscal year, amounts in the Grad-
uate Medical Education Trust Fund under section 
9512 of the Internal Revenue Code of 1986 shall be 
available, without further appropriation, to the Sec-
retary to carry out this section. 
‘‘(2) TRANSFERS TO GME TRUST FUND.—There 
shall be provided for the transfer to the Graduate 
Medical Education Trust Fund by the Medicare 
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