In the Senate of the United States,
September 26, 2006.
Resolved, That the bill from the House of Representa-
tives (H.R. 5574) entitled ‘‘An Act to amend the Public
Health Service Act to reauthorize support for graduate med-
ical education programs in children’s hospitals.’’, do pass
with the following
AMENDMENT:
Strike out all after the enacting clause and insert:
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Children’s Hospital
GME Support Reauthorization Act of 2006’’.
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HR 5574 EAS
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 fis-
cal years 2000 through 2005’’;
(2) in subsection (e)(1), by striking ‘‘26’’ and in-
serting ‘‘12’’;
(3) 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, $110,000,000.’’; and
(4) 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
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(D) by adding at the end the following:
‘‘(D) for each of fiscal years 2007 through
2011, $220,000,000.’’.
(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 FAILURE
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 pro-
vide the Secretary, as an addendum to
the hospital’s application under this
section for such fiscal year, the report
required under subparagraph (B) for
the previous fiscal year; or
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‘‘(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 in-
formation within such period, no reduction
shall be made under clause (i) on the basis
of the previous failure to provide such infor-
mation.
‘‘(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 resi-
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dency academic year completed immediately
prior to such fiscal year:
‘‘(i) The types of resident training pro-
grams that the hospital provided for resi-
dents described in subparagraph (C), such
as general pediatrics, internal medicine/pe-
diatrics, and pediatric subspecialties, in-
cluding both medical subspecialties certified
by the American Board of Pediatrics (such
as pediatric gastroenterology) and non-med-
ical subspecialties approved by other med-
ical 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 chil-
dren who are underserved for reasons of
family income or geographic location, in-
cluding rural and urban areas.
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‘‘(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 described
in subparagraph (C) who completed their
residency training at the end of such resi-
dency academic year and care for children
within the borders of the service area of the
hospital or within the borders of the State
in which the hospital is located. Such num-
bers shall be disaggregated with respect to
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residents who completed residencies in gen-
eral pediatrics or internal medicine/pediat-
rics, subspecialty residencies, and dental
residencies.
‘‘(C) RESIDENTS.—The residents described
in this subparagraph are those who—
‘‘(i) are in full-time equivalent resident
training positions in any training program
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 im-
provements to the program.’’.
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(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 Secu-
rity Act for discharges occurring during the preceding
fiscal year’’;
(2) in subsection (e)(2), by striking the first sen-
tence; and
(3) in subsection (e)(3), by striking ‘‘made to
pay’’ and inserting ‘‘made and pay’’.
Attest:
Secretary.