I 
115TH CONGRESS 
2D SESSION 
H. R. 7233 
To amend the Public Health Service Act to authorize grants for graduate 
medical education partnerships in States with a low ratio of medical 
residents relative to the general population. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 10, 2018 
Ms. CASTOR of Florida introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to authorize grants 
for graduate medical education partnerships in States 
with a low ratio of medical residents relative to the 
general population. 
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 ‘‘Creating Access to 
Residency Education Act of 2018’’. 
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SEC. 2. GRADUATE MEDICAL EDUCATION PARTNERSHIPS 
IN STATES WITH A LOW RATIO OF MEDICAL 
RESIDENTS RELATIVE TO GENERAL POPU-
LATION. 
Part B of title III of the Public Health Service Act 
is amended by inserting after section 317T (42 U.S.C. 
247b–22) the following: 
‘‘SEC. 317U. GRADUATE MEDICAL EDUCATION PARTNER-
SHIPS IN STATES WITH A LOW RATIO OF MED-
ICAL RESIDENTS RELATIVE TO GENERAL 
POPULATION. 
‘‘(a) IN GENERAL.—The Administrator of the Cen-
ters for Medicare & Medicaid Services (in this section re-
ferred to as the ‘Administrator’) shall make grants to, or 
enter into contracts with, eligible entities to support the 
creation of new medical residency training programs or 
slots within existing programs in States in which there is 
a low ratio of medical residents relative to the general pop-
ulation. 
‘‘(b) ELIGIBILITY.—To be eligible to receive Federal 
funding under this section, an entity must— 
‘‘(1) be located in a State in which there are 
fewer than 30 medical residents per population of 
100,000; and 
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‘‘(2) be a public or nonprofit teaching hospital 
or an accredited graduate medical education training 
program. 
‘‘(c) PARTNERSHIPS.—In supporting the creation of 
new medical residency training programs or slots through 
a grant or contract under this section, an eligible entity 
may enter into a partnership with a State, local govern-
ment, community health center, local health department, 
hospital, or other organization deemed by the entity to be 
appropriate. 
‘‘(d) MATCHING FUNDS.—An agreement awarding a 
grant or contract under this section shall— 
‘‘(1) in the case of a new or existing medical 
residency training program in the field of primary 
care— 
‘‘(A) require the entity awarded such grant 
or contract to provide one-third of the cost of 
the slots to be funded through the agreement; 
and 
‘‘(B) to the extent and in the amounts 
made available in advance in appropriations 
Acts, require the Administrator to provide the 
remaining two-thirds of the cost of such slots; 
and 
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