I 
114TH CONGRESS 
1ST SESSION H. R. 3755 
To amend title XVIII of the Social Security Act to provide for the disregard 
of certain resident slots that include Department of Veterans Affairs 
training in determining payments for direct graduate medical education 
costs, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 9, 2015 
Ms. TITUS (for herself, Mr. TAKANO, and Mr. BECERRA) introduced the fol-
lowing bill; which was referred to the Committee on Ways and Means, 
and in addition to the Committees on Energy and Commerce and Vet-
erans’ Affairs, for a period to be subsequently determined by the Speaker, 
in each case for consideration of such provisions as fall within the juris-
diction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for the disregard of certain resident slots that include 
Department of Veterans Affairs training in determining 
payments for direct graduate medical education costs, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. DISREGARD OF RESIDENT SLOTS THAT IN-
CLUDE VA TRAINING AGAINST THE MEDI-
CARE GRADUATE MEDICAL EDUCATION LIMI-
TATIONS. 
(a) DIRECT GME.—Section 1886(h)(4)(F) of the So-
cial Security Act (42 U.S.C. 1395ww(h)(4)(F)) is amend-
ed by adding at the end the following new clause: 
‘‘(iii) DISREGARD OF CERTAIN RESI-
DENT
SLOTS
THAT
INCLUDE
VA
TRAIN-
ING.—For portions of cost reporting peri-
ods beginning on or after July 1, 2016, in 
applying the limitations regarding the total 
number of full-time equivalent residents in 
the field of allopathic or osteopathic medi-
cine under clause (i) in a hospital’s ap-
proved medical residency training program, 
the Secretary shall not take into account 
any resident within such program that 
counts towards meeting the obligation of 
the Secretary of Veterans Affairs under 
section 301(b)(2) of the Veterans Access, 
Choice, and Accountability Act of 2014 
(Public Law 113–146; 38 U.S.C. 7302 
note).’’. 
(b) INDIRECT GME.—Section 1886(d)(5)(B)(v) of 
the Social Security Act (42 U.S.C. 1395ww(d)(5)(B)(v)) 
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is amended, in the second sentence, by striking ‘‘sub-
section (h)(4)(F)(ii)’’ and inserting ‘‘clauses (ii) and (iii) 
of subsection (h)(4)(F)’’. 
SEC. 2. EXTENSION OF PERIOD FOR INCREASE IN GRAD-
UATE MEDICAL EDUCATION RESIDENCY PO-
SITIONS AT MEDICAL FACILITIES OF THE DE-
PARTMENT OF VETERANS AFFAIRS. 
(a) IN GENERAL.—Paragraph (2) of section 301(b) 
of the Veterans Access, Choice, and Accountability Act of 
2014 (Public Law 113–146; 38 U.S.C. 7302 note) is 
amended— 
(1) in the paragraph heading, by striking 
‘‘FIVE-YEAR’’ and inserting ‘‘TEN-YEAR’’; and 
(2) in subparagraph (A), by striking ‘‘5-year 
period’’ and inserting ‘‘10-year period’’. 
(b) REPORT.—Paragraph (3)(A) of such section is 
amended by striking ‘‘2019’’ and inserting ‘‘2024’’. 
Æ 
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