I 
109TH CONGRESS 
1ST SESSION H. R. 1246 
To reauthorize the Children’s Hospitals Graduate Medical Education 
Program. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 10, 2005 
Mrs. JOHNSON of Connecticut (for herself, Ms. PRYCE of Ohio, Mr. BROWN 
of Ohio, Mr. BACHUS, Ms. BALDWIN, Mrs. BONO, Ms. ESHOO, Mr. 
HALL, Mr. HULSHOF, Mr. RUSH, Mr. SESSIONS, Mr. SHAYS, Mr. 
SHIMKUS, Mr. SIMMONS, Ms. SOLIS, and Mr. WAXMAN) introduced the 
following bill; which was referred to the Committee on Energy and Com-
merce 
A BILL 
To reauthorize the Children’s Hospitals Graduate Medical 
Education Program. 
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 Hospitals 
Education Equity and Research (CHEER) Act of 2005’’.
SEC. 2. REAUTHORIZATION OF CHILDREN’S HOSPITALS 
GRADUATE MEDICAL EDUCATION PROGRAM. 
(a) EXTENSION OF PROGRAM.—Section 340E(a) of 
the Public Health Service Act (42 U.S.C. 256e(a)) is 
amended by striking ‘‘2005’’ and inserting ‘‘2010’’. 
(b) DIRECT GRADUATE MEDICAL EDUCATION.—Sec-
tion 340E(c) of the Public Health Service Act (42 U.S.C. 
256e(c)) is amended— 
(1) in paragraph (1)(B), by inserting ‘‘but with-
out giving effect to section 1886(h)(7) of such Act)’’ 
after ‘‘section 1886(h)(4) of the Social Security 
Act’’; and 
(2) in paragraph (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’’. 
(c) NATURE OF PAYMENTS.—Section 340E(e)(3) of 
the Public Health Service Act (42 U.S.C. 256e(e)(3)) is 
amended by striking ‘‘made to pay’’ and inserting ‘‘made 
and pay’’. 
(d) AUTHORIZATION OF APPROPRIATIONS.—Section 
340E(f) of the Public Health Service Act (42 U.S.C. 
256e(f)) is amended— 
(1) in paragraph (1)(A)— 
(A) in clause (ii), by striking ‘‘and’’;
(B) in clause (iii), by striking the period 
and inserting a semicolon; and 
(C) by adding at the end the following: 
‘‘(iv) 
for 
fiscal 
year 
2006, 
$110,000,000; and 
‘‘(v) for each of fiscal years 2007 
through 2010, such sums as may be nec-
essary.’’; and 
(2) in paragraph (2)— 
(A) in the matter preceding subparagraph 
(A)— 
(i) by striking ‘‘There are hereby au-
thorized’’ and inserting ‘‘There are author-
ized’’; and 
(ii) by striking ‘‘(b)(1)(A)’’ and in-
serting ‘‘(b)(1)(B)’’; 
(B) in subparagraph (B), by striking 
‘‘and’’; 
(C) in subparagraph (C), by striking the 
period and inserting a semicolon; and 
(D) by adding at the end the following: 
‘‘(D) for fiscal year 2006, $220,000,000; 
and 
‘‘(E) for each of fiscal years 2007 through 
2010, such sums as may be necessary.’’.
(e) TECHNICAL AMENDMENT.—Section 340E(e)(2) 
of the Public Health Service Act (42 U.S.C. 256e(e)(2)) 
is amended by striking the first sentence. 
(f) EXTENDING AVAILABILITY OF FUNDS THROUGH 
THE FOLLOWING FISCAL YEAR.— 
(1) IN GENERAL.—Section 340E(f) of the Pub-
lic Health Service Act (42 U.S.C. 256e(f)) is amend-
ed— 
(A) in paragraph (1)(B)— 
(i) by inserting ‘‘or for fiscal year 
2006 (or any succeeding fiscal year)’’ after 
‘‘for fiscal year 2000’’; and 
(ii) by striking ‘‘fiscal year 2001’’ and 
inserting ‘‘the end of the succeeding fiscal 
year’’; and 
(B) by adding at the end of paragraph (2) 
the following: 
‘‘The amounts appropriated under this paragraph 
for a fiscal year (beginning with fiscal year 2006) 
shall remain available for obligation through the end 
of the succeeding fiscal year.’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
340E(b)(2)(A) of the Public Health Service Act (42 
U.S.C. 256e(b)(2)(A)) is amended by inserting be-
fore the period at the end the following: ‘‘plus the
funds remaining available from the previous fiscal 
year under paragraph (1)(B) or the second sentence 
of paragraph (2), respectively, of such subsection’’. 
(g) REDISTRIBUTION
OF RECOUPED AMOUNTS.— 
Section 340E(e)(3) of the Public Health Service Act (42 
U.S.C. 256e(e)(3)) is amended by striking ‘‘to the extent 
possible.’’ and inserting a period and the following: ‘‘To 
the greatest extent possible, amounts recouped from a hos-
pital are to be distributed to other hospitals in the same 
fiscal year. Unless there is fraud, amounts paid to a hos-
pital without a demand for recoupment by the end of the 
fiscal year shall be final and not subject to recoupment.’’. 
(h) APPEALS PROCEDURES.—Section 340E(e) of the 
Public Health Service Act (42 U.S.C. 256e(e)) is amend-
ed— 
(1) in paragraph (3), by striking the last sen-
tence; and 
(2) by adding at the end the following: 
‘‘(4) APPEALS.— 
‘‘(A) IN
GENERAL.—A decision affecting 
the amount payable to a hospital pursuant to 
this section shall— 
‘‘(i) be subject to review under section 
1878 of the Social Security Act in the 
same manner as final determinations of