146 
Choices Commission in appropriate part from the 
Federal Hospital Insurance Trust Fund under sec-
tion 1817 and the Federal Supplementary Medical 
Insurance Trust Fund under section 1841 of the fol-
lowing: 
‘‘(A) For fiscal year 2015, an amount 
equal to the aggregate amount that would have 
been calculated under subsection (b)(1) for such 
fiscal year for all hospitals with approved med-
ical residency training programs if the percent-
age described in paragraph (1)(B) of such sub-
section were 82 percent. 
‘‘(B) For fiscal year 2016 and each subse-
quent fiscal year, the amount transferred under 
this paragraph for the previous fiscal year in-
creased by the annual percentage increase in 
the medical component of the Consumer Price 
Index for All Urban Consumers (all items; 
United States city average) as of June of the 
previous fiscal year. 
‘‘(f) DEFINITIONS.—The terms ‘approved medical 
residency training program’ and ‘direct graduate medical 
education costs’ have the meanings given such terms 
under section 1886(h)(5).’’. 
(b) GME TRUST FUND.— 
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147 
(1) IN GENERAL.—Subchapter A of chapter 98 
of the Internal Revenue Code of 1986 is amended by 
adding at the end the following new section: 
‘‘SEC. 9512. GRADUATE MEDICAL EDUCATION TRUST FUND. 
‘‘(a) IN GENERAL.—There is established in the 
Treasury of the United States a trust fund to be known 
as the ‘Graduate Medical Education Trust Fund’ (here-
after in this section referred to as the ‘GME Trust Fund’), 
consisting of such amounts as may be appropriated or 
credited to such Trust Fund as provided in this section 
and section 9602(b). 
‘‘(b) TRANSFERS TO FUND.— 
‘‘(1) TRUST FUND TRANSFERS.—There shall be 
credited to the GME Trust Fund for fiscal year 
2015 and each subsequent fiscal year— 
‘‘(A) the amounts transferred under sec-
tion 1899B of the Social Security Act; and 
‘‘(B) the amounts transferred from the Pa-
tient-Centered Outcomes Research Trust Fund 
under section 9511(g). 
‘‘(2) APPROPRIATION.—There are hereby ap-
propriated to the GME Trust Fund for fiscal year 
2015 and each subsequent fiscal year an amount 
equal to the aggregate payment amounts determined 
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148 
for such fiscal year under section 1899B(b)(2) of 
the Social Security Act. 
‘‘(3) AUTHORIZATION OF APPROPRIATIONS.—In 
addition to amounts credited to the GME Trust 
Fund under paragraph (1) for a fiscal year, there 
are authorized to be appropriated to the Trust 
Fund— 
‘‘(A) for each of fiscal years 2015 and 
2016, $200,000,000; and 
‘‘(B) for each of fiscal years 2017 and 
2018, $100,000,000. 
‘‘(c) EXPENDITURES FROM FUND.—Amounts in the 
GME Trust Fund are available, without further appro-
priation, to the Secretary for carrying out section 1899B 
of the Social Security Act.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions for subchapter A of chapter 98 of such Code 
is amended by adding at the end the following new 
item: 
‘‘Sec. 9512. Graduate Medical Education Trust Fund.’’. 
(c) CONFORMING AMENDMENTS.— 
(1) SUNSET MEDICARE GME.—Section 1886 of 
the Social Security Act (42 U.S.C. 1395ww) is 
amended— 
(A) in subsection (d)(5)(B)— 
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149 
(i) by redesignating the second clause 
(x) as clause (xi); and 
(ii) by adding at the end the following 
new clause: 
‘‘(xii) For cost reporting periods beginning 
on or after October 1, 2014, no additional pay-
ment amount for subsection (d) hospitals with 
indirect costs of medical education shall be 
made under this subparagraph and instead pay-
ments for such costs shall be made in accord-
ance with section 1899B.’’; and 
(B) in subsection (h)(1), by adding at the 
end the following new sentence: ‘‘For cost re-
porting periods beginning on or after October 1, 
2014, no payments for direct graduate medical 
education costs shall be made under this sub-
section and instead payments for such costs 
shall be made in accordance with section 
1899B.’’. 
(2) SUNSET MEDICAID GME.—Section 1903(i) 
of the Social Security Act (42 U.S.C. 1396b(i)) is 
amended— 
(A) in paragraph (25), by striking ‘‘or’’ at 
the end; 
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150 
(B) in paragraph (26), by striking the pe-
riod at the end and inserting ‘‘; or’’; and 
(C) by inserting after paragraph (26) the 
following new paragraph: 
‘‘(27) with respect to any amounts expended on 
or after October 1, 2014, for payments to hospitals 
for direct or indirect costs of graduate medical edu-
cation.’’. 
(3) SUNSET
PHSA
CHILDREN’S
HOSPITAL 
GME.—Section 340E of the Public Health Service 
Act (42 U.S.C. 256e) is amended— 
(A) in the first sentence of subsection (a), 
by striking ‘‘The Secretary’’ and inserting 
‘‘Subject to subsection (h), the Secretary’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(h) SUNSET.—For fiscal year 2015 and each subse-
quent fiscal year, no payments shall be made under this 
section to a children’s hospital for the direct expenses and 
the indirect expenses associated with operating approved 
graduate medical residency training programs and instead 
payments for such expenses shall be made to such hospital 
in accordance with section 1899B of the Social Security 
Act.’’. 
(4) TRANSFER OF PCORI FUNDS.— 
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151 
(A) MEDICARE TRANSFER.—Section 1183 
of the Social Security Act is amended— 
(i) in the heading, by striking ‘‘PA-
TIENT-CENTERED
OUTCOMES
RE-
SEARCH
TRUST
FUND’’ and inserting 
‘‘GRADUATE
MEDICAL
EDUCATION 
TRUST FUND’’; and 
(ii) in subsection (a), by striking ‘‘to 
the Patient-Centered Outcomes Research 
Trust Fund (referred to in this section as 
the ‘PCORTF’) under section 9511 of the 
Internal Revenue Code of 1986’’ and in-
serting ‘‘to the Graduate Medical Edu-
cation Trust Fund under section 9512 of 
the Internal Revenue Code of 1986’’. 
(B) PCORI TRUST FUND.—Section 9511 
of the Internal Revenue Code of 1986 is 
amended— 
(i) in subsection (d)(1), by inserting 
‘‘and subsection (g)’’ after ‘‘paragraph 
(2)’’; and 
(ii) by adding at the end the following 
new subsection: 
‘‘(g) TRANSFER TO GRADUATE MEDICAL EDUCATION 
TRUST FUND.—The Secretary of the Treasury shall 
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