I 
109TH CONGRESS 
2D SESSION 
H. R. 5574 
To amend the Public Health Service Act to reauthorize support for graduate 
medical education programs in children’s hospitals. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 9, 2006 
Mr. DEAL of Georgia (for himself, Mr. BROWN of Ohio, Mr. MARKEY, Mr. 
GENE GREEN of Texas, Ms. BALDWIN, Mr. PITTS, Mr. RUSH, Mr. 
RADANOVICH, Mr. SHIMKUS, Mr. BURGESS, Mr. BASS, Mrs. CAPPS, Mr. 
MURPHY, Mr. INSLEE, Mr. PALLONE, Mr. GILLMOR, Mrs. BONO, Mr. 
UPTON, Mr. HALL, Mr. WAXMAN, and Mr. WYNN) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce 
A BILL 
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’’. 
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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 
‘‘(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: 
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‘‘(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)’’ insert-
ing ‘‘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-
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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 
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Secretary) the following information relating to 
the residency training program sponsored by 
the hospital and supported under this section 
for the residency academic year completed im-
mediately prior to such fiscal year: 
‘‘(i) The types of resident training 
programs that the hospital sponsored, such 
as general pediatrics, internal medicine/pe-
diatrics, and pediatric subspecialties, in-
cluding both medical subspecialties cer-
tified by the American Board of Pediatrics 
(such as pediatric gastroenterology) and 
non-medical subspecialties approved by 
other medical certification boards (such as 
pediatric surgery). 
‘‘(ii) The number of full-time equiva-
lent resident training positions in each 
training program sponsored by the hos-
pital, the number of such positions the 
hospital recruited to fill, and the number 
of such positions filled. 
‘‘(iii) The types of training that the 
hospital provided for residents in its own 
sponsored programs related to the health 
care needs of different populations, such as 
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children who are underserved for reasons 
of family income or geographic location, in-
cluding rural, exurban, and urban areas. 
‘‘(iv) The changes in residency train-
ing the hospital has made during such resi-
dency 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 section), in-
cluding— 
‘‘(I) changes in curricula and 
types of training programs, and bene-
fits that have resulted from such 
changes; and 
‘‘(II) changes for purposes of 
training the residents in its own spon-
sored programs in the measurement 
and improvement of the quality and 
safety of patient care. 
‘‘(v) The numbers of residents who, 
upon completion of a hospital’s sponsored 
training program at the end of such resi-
dency academic year, care for children 
within the borders of the service area of 
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the hospital or within the borders of the 
State in which the hospital is located. Such 
numbers shall be disaggregated with re-
spect to residents who completed initial 
board 
certification, 
subspecialty 
residencies, and dental residencies. 
‘‘(C) 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-
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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’’. 
Æ 
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