SEC. 2. MEDICARE GME TREATMENT OF HOSPITALS ESTAB-
LISHING NEW MEDICAL RESIDENCY TRAIN-
ING PROGRAMS AFTER HOSTING MEDICAL 
RESIDENT ROTATORS FOR SHORT DURA-
TIONS. 
(a) REDETERMINATION OF APPROVED FTE RESI-
DENT AMOUNT.—Section 1886(h)(2)(F) of the Social Se-
curity Act (42 U.S.C. 1395ww(h)(2)(F)) is amended— 
(1) by inserting ‘‘(i)’’ before ‘‘In the case of’’; 
and 
(2) by adding at the end the following: 
‘‘(ii) In applying this subparagraph to 
a hospital that has not entered into a 
GME affiliation agreement (as defined by 
the Secretary for purposes of paragraph 
(4)(H)(ii)), the Secretary shall not provide 
for the establishment of an FTE resident 
amount until such time as the Secretary 
determines that the hospital has a medical 
residency training program that trains 
more than 1.0 full-time-equivalent resident 
in a cost reporting period. 
‘‘(iii) In the case of a hospital with an 
approved FTE resident amount— 
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‘‘(I) based on the training of less 
than 1.0 full-time-equivalent resident 
before October 1, 1997, or 
‘‘(II) based on the training of no 
more than 3.0 full-time-equivalent 
residents in a new medical residency 
training program in any cost report-
ing period beginning on or after Octo-
ber 1, 1997, and before the date of 
the enactment of this clause, or 
‘‘(III) based on the training of no 
full-time-equivalent residents in a 
medical residency training program 
for any ten consecutive cost reporting 
periods beginning on or after October 
1, 1997, 
the Secretary shall provide the hospital an 
opportunity to have a new FTE resident 
amount established when the hospital be-
gins training at least 1.0 full-time equiva-
lent resident (in the case of a hospital de-
scribed in subclauses (I or III)) or more 
than 3.0 full-time-equivalent residents (in 
the case of a hospital described in sub-
clause (II)) for cost reporting periods be-
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ginning on or after the date of the enact-
ment of this clause and in accordance with 
the methodology under the rules in effect 
as of October 1, 2015.’’. 
(b) REDETERMINATION OF FTE RESIDENT LIMITA-
TION.—Section 1886(h)(4)(H)(i) of the Social Security 
Act (42 U.S.C. 1395ww(h)(4)(H)(i)) is amended— 
(1) by inserting ‘‘(I)’’ before ‘‘The Secretary’’; 
and 
(2) by adding at the end the following: 
‘‘(II) Under this clause the Sec-
retary shall not determine an adjust-
ment in the limitation applicable to a 
hospital under subparagraph (F) until 
the hospital trains more than 1.0 full- 
time equivalent resident in a new 
medical residency training program in 
a cost reporting period. 
‘‘(III) In the case of a hospital 
that has a limitation under subpara-
graph (F) of less than 1.0 full-time- 
equivalent resident as of the date of 
the enactment of this subclause based 
on training before October 1, 1997, 
under this clause the Secretary shall 
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provide the hospital an opportunity to 
have a new adjustment in such limita-
tion determined when such hospital 
begins training at least 1.0 full-time 
equivalent resident in accordance with 
the methodology applicable to hos-
pitals under the rules in effect as of 
October 1, 2015, and applied for cost 
reporting periods beginning on or 
after the date of the enactment of this 
subclause. 
‘‘(IV) In the case of a hospital 
that has not reported full-time-equiva-
lent residents in ten consecutive cost 
reporting periods subsequent to Octo-
ber 1, 1997, under this clause the 
Secretary shall provide the hospital an 
opportunity to have a new adjustment 
in such limitation determined when 
such hospital begins training at least 
1.0 full-time equivalent resident in ac-
cordance with the methodology appli-
cable to hospitals under the rules in 
effect as of October 1, 2015, and ap-
plied for cost reporting periods begin-
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ning on or after the date of the enact-
ment of this subclause. 
‘‘(V) In the case of a hospital for 
which an adjustment in the limitation 
applicable to a hospital under sub-
paragraph (F) is based on the train-
ing of no more than 3.0 full-time- 
equivalent residents in a new medical 
residency training program in a cost 
reporting period beginning on or after 
October 1, 1997, and before the date 
of the enactment of this subclause, 
the Secretary shall provide the hos-
pital an opportunity to have a new ad-
justment in such limitation deter-
mined when the hospital begins train-
ing more than 3.0 full-time-equivalent 
residents in accordance with the meth-
odology applicable to hospitals under 
the rules in effect as of October 1, 
2015, and applied for cost reporting 
periods beginning on or after the date 
of the enactment of this subclause.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to payment under section 1886 of 
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the Social Security Act (42 U.S.C. 1395ww) for cost re-
porting periods beginning on or after the date of the en-
actment of this Act. 
Æ 
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