I 
115TH CONGRESS 
1ST SESSION H. R. 3394 
To reauthorize section 340H of the Public Health Service Act to continue 
to encourage the expansion, maintenance, and establishment of approved 
graduate medical residency programs at qualified teaching health centers, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 25, 2017 
Mrs. MCMORRIS RODGERS (for herself, Mr. CARTER of Georgia, Mr. HECK, 
Mr. KENNEDY, Mr. KHANNA, Mr. LAMALFA, Mr. MCGOVERN, Mr. 
O’HALLERAN, Mr. RASKIN, Mr. VELA, Mr. YOUNG of Iowa, Mr. CAPU-
ANO, Mr. CARTWRIGHT, Mr. CROWLEY, Mr. DENHAM, Mr. ESPAILLAT, 
Mr. FASO, Ms. JENKINS of Kansas, Mr. KILMER, Mr. MOULTON, Mr. 
NEWHOUSE, Mr. TAKANO, Mr. VALADAO, Mr. COHEN, Mr. CONYERS, Mr. 
COURTNEY, Mr. DANNY K. DAVIS of Illinois, Mr. DEFAZIO, Ms. 
DELAURO, Ms. DELBENE, Mr. GARAMENDI, Mr. LARSEN of Washington, 
Mr. LONG, Mr. LUCAS, Mr. MARINO, Mr. MURPHY of Pennsylvania, Mr. 
NOLAN, Ms. ROS-LEHTINEN, Mr. RUSH, Ms. SCHAKOWSKY, Ms. SEWELL 
of Alabama, Ms. WILSON of Florida, Mr. SERRANO, Ms. TSONGAS, Ms. 
BONAMICI, Mr. RUIZ, Ms. CLARK of Massachusetts, Mr. COLE, Mr. ROG-
ERS of Kentucky, and Mr. LARSON of Connecticut) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce 
A BILL 
To reauthorize section 340H of the Public Health Service 
Act to continue to encourage the expansion, maintenance, 
and establishment of approved graduate medical resi-
dency programs at qualified teaching health centers, and 
for other purposes. 
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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 ‘‘Teaching Health Cen-
ters Graduate Medical Education Extension Act of 2017’’. 
SEC. 2. FINDINGS. 
The Congress finds as follows: 
(1) The program of payments to teaching 
health centers for graduate medical education under 
section 340H of the Public Health Service Act (42 
U.S.C. 256h) was enacted in 2010 to address the 
crisis-level shortage of primary care physicians, espe-
cially in rural and medically underserved commu-
nities. 
(2) Teaching health center residents and faculty 
will provide more than one million primary care 
medical visits in 2017 to underserved communities. 
(3) When compared with traditional Medicare 
GME residents, residents who train at teaching 
health centers are more likely to practice primary 
care and remain in underserved or rural commu-
nities. 
(4) The teaching health center program not 
only plays a vital role in training the Nation’s next 
generation of primary care physicians (including 
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dentists), but helps bridge the Nation’s physician 
shortfall. 
(5) For these reasons, it is of vital importance 
to continue the program under section 340H of the 
Public Health Service Act (42 U.S.C. 256h) at a 
sustainable level of funding per full-time equivalent 
resident, as recommended in the fact sheet of the 
Health Resources and Services Administration enti-
tled ‘‘Cost Estimates for Training Residents in a 
Teaching Health Center’’. 
SEC. 3. REAUTHORIZATION OF PROGRAM OF PAYMENTS TO 
TEACHING HEALTH CENTERS THAT OPERATE 
GRADUATE 
MEDICAL 
EDUCATION 
PRO-
GRAMS. 
(a) PAYMENTS.—Subsection (a) of section 340H of 
the Public Health Service Act (42 U.S.C. 256h) is amend-
ed to read as follows: 
‘‘(a) PAYMENTS.— 
‘‘(1) IN
GENERAL.—Subject to subsection 
(h)(2), the Secretary shall make payments under 
this section for direct expenses and indirect expenses 
to qualified teaching health centers that are listed as 
sponsoring institutions by the relevant accrediting 
body for— 
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‘‘(A) maintenance of existing approved 
graduate medical residency training programs; 
‘‘(B) expansion of existing approved grad-
uate medical residency training programs; and 
‘‘(C) establishment of new approved grad-
uate medical residency training programs. 
‘‘(2) NEW PROGRAMS.— 
‘‘(A) PAYMENTS.—The Secretary shall 
make payments under paragraph (1)(C)— 
‘‘(i) for fiscal year 2019, for a total of 
up to 60 full-time equivalent residents at 
new approved graduate medical residency 
programs; and 
‘‘(ii) for fiscal year 2020, for a total 
of up to 120 full-time equivalent residents 
at the new approved graduate medical resi-
dency programs that received payments 
pursuant to clause (i). 
‘‘(B) PRIORITY.—Subject to subparagraph 
(C), in making payments pursuant to para-
graph (1)(C), the Secretary shall give priority 
to qualified teaching health centers that— 
‘‘(i) serve a health professional short-
age area with a designation in effect under 
section 332 or a medically underserved 
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community (as defined in section 799B); 
or 
‘‘(ii) are located in a rural area (as 
defined in section 1886(d)(2)(D) of the So-
cial Security Act). 
‘‘(C) LIMITATION.—The number of full- 
time equivalent residents for which a qualified 
teaching health center receives payments pursu-
ant to paragraph (1)(C) for a fiscal year shall 
not exceed by more than six the number of full- 
time equivalent residents for which the center 
received such payments for the preceding fiscal 
year.’’. 
(b) FUNDING.—Subsection (g) of the first section 
340H of the Public Health Service Act (42 U.S.C. 256h) 
is amended to read as follows: 
‘‘(g) FUNDING.— 
‘‘(1) EXISTING PROGRAMS.—Out of any money 
in the Treasury not otherwise appropriated, there 
are appropriated for payments under subparagraphs 
(A) and (B) of subsection (a)(1) $116,500,000 for 
each of fiscal years 2018, 2019, and 2020, to re-
main available until expended. 
‘‘(2) INCENTIVE FOR NEW PROGRAMS.—Out of 
any money in the Treasury not otherwise appro-
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priated, there are appropriated for payments under 
subsection (a)(1)(C), $10,000,000 for fiscal year 
2019 and $19,000,000 for fiscal year 2020, to re-
main available until expended. 
‘‘(3) 
ADMINISTRATIVE
EXPENSES.—Of 
the 
amount made available to carry out this section for 
any fiscal year, the Secretary may not use more 
than 5 percent of such amount for the expenses of 
administering this section.’’. 
(c) ANNUAL REPORTING.—Paragraph (1) of sub-
section (h) of the first section 340H of the Public Health 
Service Act (42 U.S.C. 256h) is amended— 
(1) by redesignating subparagraph (D) as sub-
paragraph (H); and 
(2) by inserting after subparagraph (C) the fol-
lowing: 
‘‘(D) The number of patients treated by 
residents described in paragraph (4). 
‘‘(E) The number of visits by patients 
treated by residents described in paragraph (4). 
‘‘(F) Of the number of residents described 
in paragraph (4) who completed their residency 
training at the end of such residency academic 
year, the number and percentage of such resi-
dents entering primary care practice (meaning 
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any of the areas of practice listed in the defini-
tion of a primary care residency program in 
section 749A). 
‘‘(G) Of the number of residents described 
in paragraph (4) who completed their residency 
training at the end of such residency academic 
year, the number and percentage of such resi-
dents who entered practice at a health care fa-
cility— 
‘‘(i) primarily serving a health profes-
sional shortage area with a designation in 
effect under section 332 or a medically un-
derserved community (as defined in section 
799B); or 
‘‘(ii) located in a rural area (as de-
fined in section 1886(d)(2)(D) of the So-
cial Security Act).’’. 
(d) REPORT ON TRAINING COSTS.—Not later than 
March 31, 2020, the Secretary of Health and Human 
Services shall submit to the Congress a report on the di-
rect graduate expenses of approved graduate medical resi-
dency training programs, and the indirect expenses associ-
ated with the additional costs of teaching residents, of 
qualified teaching health centers (as such terms are used 
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or defined in section 340H of the Public Health Service 
Act (42 U.S.C. 256h)). 
(e) DEFINITION.—Subsection (j) of the first section 
340H of the Public Health Service Act (42 U.S.C. 256h) 
is amended— 
(1) by redesignating paragraphs (2) and (3) as 
paragraphs (3) and (4), respectively; and 
(2) by inserting after paragraph (1) the fol-
lowing: 
‘‘(2) NEW
APPROVED
GRADUATE
MEDICAL 
RESIDENCY
TRAINING
PROGRAM.—The term ‘new 
approved graduate medical residency training pro-
gram’ means an approved graduate medical resi-
dency training program for which the sponsoring 
qualified teaching health center has not received a 
payment under this section for a previous fiscal year 
(other than pursuant to subsection (a)(1)(C)).’’. 
(f) TECHNICAL CORRECTIONS.—Part D of title III 
of the Public Health Service Act (42 U.S.C. 254b et seq.) 
is amended— 
(1) in subsection (f) of the first section 340H 
(42 U.S.C. 256h), by striking ‘‘hospital’’ each place 
it appears and inserting ‘‘teaching health center’’; 
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(2) by redesignating the second subpart XI (re-
lating to a community-based collaborative care net-
work program) as subpart XII; and 
(3) by redesignating the second section 340H 
(42 U.S.C. 256i) as section 340I. 
(g) PAYMENTS FOR PREVIOUS FISCAL YEARS.—The 
provisions of the first section 340H of the Public Health 
Service Act (42 U.S.C. 256h), as in effect on the day be-
fore the date of enactment of this Act, shall continue to 
apply with respect to payments under such section for fis-
cal years before fiscal year 2018. 
Æ 
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