109TH CONGRESS 
2D SESSION 
H. R. 5574
AN ACT 
To amend the Public Health Service Act to reauthorize sup-
port for graduate medical education programs in chil-
dren’s hospitals.
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 ‘‘Children’s Hospital 
GME Support Reauthorization Act of 2006’’. 
SEC. 2. PROGRAM OF PAYMENTS TO CHILDREN’S HOS-
PITALS THAT OPERATE GRADUATE MEDICAL 
EDUCATION PROGRAMS. 
(a) IN GENERAL.—Section 340E of the Public 
Health Service Act (42 U.S.C. 256e) is amended—
(1) in subsection (a), by inserting ‘‘and each of 
fiscal years 2007 through 2011’’ after ‘‘for each of 
fiscal years 2000 through 2005’’; 
(2) in subsection (f)(1)(A)—
(A) in clause (ii), by striking ‘‘and’’ at the 
end; 
(B) in clause (iii), by striking the period at 
the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(iv) for each of fiscal years 2007 
through 2011, $100,000,000.’’; and 
(3) in subsection (f)(2)—
(A) in the matter before subparagraph (A), 
by striking ‘‘subsection (b)(1)(A)’’ and inserting 
‘‘subsection (b)(1)(B)’’; 
(B) in subparagraph (B), by striking 
‘‘and’’ at the end;
(C) in subparagraph (C), by striking the 
period at the end and inserting ‘‘; and’’; and 
(D) by adding at the end the following: 
‘‘(D) for each of fiscal years 2007 through 
2011, $200,000,000.’’. 
(b) REDUCTION
IN PAYMENTS
FOR FAILURE
TO 
FILE ANNUAL REPORT.—Subsection (b) of section 340E 
of the Public Health Service Act (42 U.S.C. 256e) is 
amended—
(1) in paragraph (1), in the matter before sub-
paragraph (A), by striking ‘‘paragraph (2)’’ and in-
serting ‘‘paragraphs (2) and (3)’’; and 
(2) by adding at the end the following: 
‘‘(3) ANNUAL REPORTING REQUIRED.—
‘‘(A) REDUCTION IN PAYMENT FOR FAIL-
URE TO REPORT.—
‘‘(i) IN GENERAL.—The amount pay-
able under this section to a children’s hos-
pital for a fiscal year (beginning with fiscal 
year 2008 and after taking into account 
paragraph (2)) shall be reduced by 25 per-
cent if the Secretary determines that—
‘‘(I) the hospital has failed to 
provide the Secretary, as an adden-
dum to the hospital’s application
under this section for such fiscal year, 
the report required under subpara-
graph (B) for the previous fiscal year; 
or 
‘‘(II) such report fails to provide 
the information required under any 
clause of such subparagraph. 
‘‘(ii) NOTICE AND OPPORTUNITY TO 
PROVIDE
MISSING
INFORMATION.—Before 
imposing a reduction under clause (i) on 
the basis of a hospital’s failure to provide 
information described in clause (i)(II), the 
Secretary shall provide notice to the hos-
pital of such failure and the Secretary’s in-
tention to impose such reduction and shall 
provide the hospital with the opportunity 
to provide the required information within 
a period of 30 days beginning on the date 
of such notice. If the hospital provides 
such information within such period, no re-
duction shall be made under clause (i) on 
the basis of the previous failure to provide 
such information. 
‘‘(B) ANNUAL
REPORT.—The report re-
quired under this subparagraph for a children’s
hospital for a fiscal year is a report that in-
cludes (in a form and manner specified by the 
Secretary) the following information for the 
residency academic year completed immediately 
prior to such fiscal year: 
‘‘(i) The types of resident training 
programs that the hospital provided for 
residents described in subparagraph (C), 
such as general pediatrics, internal medi-
cine/pediatrics, and pediatric subspecial-
ties, including both medical subspecialties 
certified by the American Board of Pediat-
rics (such as pediatric gastroenterology) 
and non-medical subspecialties approved by 
other medical certification boards (such as 
pediatric surgery). 
‘‘(ii) The number of training positions 
for residents described in subparagraph 
(C), the number of such positions recruited 
to fill, and the number of such positions 
filled. 
‘‘(iii) The types of training that the 
hospital provided for residents described in 
subparagraph (C) related to the health 
care needs of different populations, such as
children who are underserved for reasons 
of family income or geographic location, in-
cluding rural and urban areas. 
‘‘(iv) The changes in residency train-
ing for residents described in subparagraph 
(C) which the hospital has made during 
such residency academic year (except that 
the first report submitted by the hospital 
under this subparagraph shall be for such 
changes since the first year in which the 
hospital received payment under this sec-
tion), including—
‘‘(I) changes in curricula, train-
ing experiences, and types of training 
programs, and benefits that have re-
sulted from such changes; and 
‘‘(II) changes for purposes of 
training the residents in the measure-
ment and improvement of the quality 
and safety of patient care. 
‘‘(v) The numbers of residents de-
scribed in subparagraph (C) who com-
pleted their residency training at the end 
of such residency academic year and care 
for children within the borders of the serv-
ice area of the hospital or within the bor-
ders of the State in which the hospital is 
located. 
Such 
numbers 
shall 
be 
disaggregated with respect to residents 
who completed residencies in general pedi-
atrics or internal medicine/pediatrics, sub-
specialty 
residencies, 
and 
dental 
residencies. 
‘‘(C) RESIDENTS.—The residents described 
in this subparagraph are those who—
‘‘(i) are in full-time equivalent resi-
dent training positions in any training pro-
gram sponsored by the hospital; or 
‘‘(ii) are in a training program spon-
sored by an entity other than the hospital, 
but who spend more than 75 percent of 
their training time at the hospital. 
‘‘(D) REPORT
TO
CONGRESS.—Not later 
than the end of fiscal year 2011, the Secretary, 
acting through the Administrator of the Health 
Resources and Services Administration, shall 
submit a report to the Congress—
‘‘(i) summarizing the information sub-
mitted in reports to the Secretary under 
subparagraph (B);
‘‘(ii) describing the results of the pro-
gram carried out under this section; and 
‘‘(iii) making recommendations for 
improvements to the program.’’. 
(c) TECHNICAL AMENDMENTS.—Section 340E of the 
Public Health Service Act (42 U.S.C. 256e) is further 
amended—
(1) in subsection (c)(2)(E)(ii), by striking ‘‘de-
scribed in subparagraph (C)(ii)’’ and inserting ‘‘ap-
plied under section 1886(d)(3)(E) of the Social Se-
curity Act for discharges occurring during the pre-
ceding fiscal year’’; 
(2) in subsection (e)(2), by striking the first 
sentence; and 
(3) in subsection (e)(3), by striking ‘‘made to 
pay’’ and inserting ‘‘made and pay’’.
Passed the House of Representatives June 21, 2006. 
Attest:
Clerk.
109TH CONGRESS 
2D SESSION 
H. R. 5574
AN ACT 
To amend the Public Health Service Act to reau-
thorize support for graduate medical education 
programs in children’s hospitals.