‘‘(B) DETERMINATION OF NATIONAL AV-
ERAGE SALARY.—
‘‘(i) 
DETERMINATION
OF
BASE
AMOUNT.—The Secretary shall determine a
base salary amount equal to the Sec-
retary’s estimate (using the most recent
available audited cost reports) of the na-
tional average salary, including fringe ben-
efits, for a full-time-equivalent resident in
an approved medical residency training
program during fiscal year 1990, increased
(in a compounded manner) by the sum of
the estimated percentage changes in the
consumer price index during the 12-month
periods between the midpoint of fiscal year
1990 and the midpoint of fiscal year 1994.
‘‘(ii) NATIONAL AVERAGE SALARY DE-
FINED.—In this paragraph, the ‘national
average salary’ for a fiscal year is equal
to—
‘‘(I) for fiscal year 1995, the
base amount determined under clause
(i) updated through the midpoint of
the year by projecting the estimated
percentage change in the consumer
price index during the 12-month pe-
riod ending at that midpoint (with ap-
propriate adjustments to reflect pre-
vious under- or over-estimations under
this subparagraph in the projected
percentage change in the consumer
price index); and
‘‘(II) for a subsequent fiscal year,
the amount determined under this
clause for the previous fiscal year up-
dated through the midpoint of the
year by projecting the estimated per-
centage change in the consumer price
index during the 12-month period
ending at that midpoint (with appro-
priate adjustments to reflect previous
under- or over-estimations under this
subparagraph in the projected per-
centage change in the consumer price
index).
‘‘(C) APPLICABLE PERCENTAGE.—In sub-
paragraph (A), the ‘applicable percentage’ is—
‘‘(i) in the case of a primary care resi-
dency training program, 200 percent; or
‘‘(ii) in the case of medical residency
training program that is not a primary
care residency training program, 150 per-
cent.
‘‘(c) ALLOCATION
OF PAYMENTS AMONG TRUST
FUNDS.—In providing for payments under this section,
the Secretary shall provide for an allocation of such pay-
ments between part A and part B (and the trust funds
established under the respective parts) as reasonably re-
flects the proportion of direct graduate medical costs of
entities associated with the provision of services under
each respective part.
‘‘(d) DEFINITIONS.—In this section:
‘‘(1) The terms ‘approved medical residency
training program’, ‘consumer price index’, ‘direct
graduate medical education costs’, and ‘resident’
have the meaning given such terms under section
1886(h)(5).
‘‘(2) The term ‘medicare patient load’ means,
with respect to an entity for a year, the fraction of
the entity’s services during the year which are at-
tributable to individuals entitled to benefits under
this title (based on such measure of services as the
Secretary determines to be appropriate for purposes
of this section).
‘‘(3) The term ‘primary care medical residency
training program’ means an approved medical resi-
dency training program consisting of a distinct pro-
gram of primary health care (as defined in section
723(d)(5) of the Public Health Service Act).’’.
(b) PAYMENT FOR HOSPITAL COSTS OF INDIRECT
MEDICAL
EDUCATION
PROVIDED
OFF-SITE.—Section
1886(d)(5)(B)(iv) of the Social Security Act (42 U.S.C.
1395ww(d)(5)(B)(iv)) is amended by inserting by striking
the period at the end and inserting the following: ‘‘, with-
out regard to the setting in which the services are fur-
nished (if the hospital incurs all, or substantially all, of
the costs of the services furnished to the hospital by such
interns and residents).’’.
(c) EFFECTIVE DATE.—The amendments made by
this section shall apply to cost reporting periods (or por-
tions thereof) beginning on or after October 1, 1994.
SEC. 6. CERTAIN PRIMARY CARE PROGRAMS UNDER PUB-
LIC HEALTH SERVICE ACT.
(a) INCREASE IN FUNDING FOR SCHOLARSHIP AND
LOAN REPAYMENT PROGRAMS OF NATIONAL HEALTH
SERVICE CORPS.—Section 338H(b)(1) of the Public
Health Service Act (42 U.S.C. 254q(b)(1)) is amended—
(1) by striking ‘‘and’’ after ‘‘1991,’’;
(2) by striking ‘‘through 2000’’ and inserting
‘‘and 1993’’; and
(3) by inserting before the period the following:
‘‘,$226,000,000 for fiscal year 1994, $294,000,000
for fiscal year 1995, $381,000,000 for fiscal year
1996, 
$496,000,000 
for 
fiscal 
year 
1997,
$644,000,000 for fiscal year 1998, $837,000,000 for
fiscal year 1999, and $1,089,000,000 for fiscal year
2000’’.
(b) DEMONSTRATION GRANTS TO STATES FOR COM-
MUNITY SCHOLARSHIP PROGRAMS.—Section 338L(l)(1)
of the Public Health Service Act (42 U.S.C. 254t(l)(1))
is amended—
(1) by striking ‘‘and’’ after ‘‘1992,’’; and
(2) by inserting before the period the following:
‘‘, and $5,000,000 for each of the fiscal years 1994
through 2000’’.
(c) NATIONAL RESEARCH SERVICE AWARDS.—Sec-
tion 487(d)(3) of the Public Health Service Act (42 U.S.C.
288(d)(3)), as amended by section 1641(2) of Public Law
103–43, is amended—
(1) by striking ‘‘1 percent’’ the first place such
terms appears and inserting ‘‘2 percent’’; and
(2) by striking ‘‘Awards which (A) are made’’
and all that follows through ‘‘(B) are for research in
primary medical care;’’ and inserting the following
‘‘Awards made for research in primary medical
care;’’.
(d) HEALTH CARE POLICY AND RESEARCH.—
(1) FUNDING.—Section 926 of the Public
Health Service Act (42 U.S.C. 299c–5), as amended
by section 10 of Public Law 102–410 (106 Stat.
2101), is amended by adding at the end the follow-
ing subsection:
‘‘(f) ALLOCATION REGARDING PRIMARY CARE.—Of
the amounts made available for a fiscal year for carrying
out this title, the Secretary shall obligate not less than
15 percent for carrying out section 902 with respect to
primary care.’’.
(2) RETRAINING
PROGRAMS.—Section 902 of
the Public Health Service Act (42 U.S.C. 299a), as
amended by section 2 of Public Law 102–410 (106
Stat. 2094), is amended by adding at the end the
following subsection:
‘‘(f) RETRAINING OF SPECIALISTS.—With respect to
physicians who are in a specialty, the Administrator shall,
in carrying out subsection (a), conduct or support pro-
grams for training such physicians in primary care.’’.
(e) COMMISSION ON OBLIGATED SERVICE.—