I 
110TH CONGRESS 
2D SESSION 
H. R. 6466 
To apply an alternative payment amount under the Medicare Program for 
certain graduate medical education programs established to train resi-
dents displaced by natural disasters. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 10, 2008 
Mr. CAZAYOUX (for himself, Mr. MELANCON, Mr. ALEXANDER, and Mr. JEF-
FERSON) introduced the following bill; which was referred to the Com-
mittee on Ways and Means, and in addition to the Committee on Energy 
and Commerce, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned 
A BILL 
To apply an alternative payment amount under the Medicare 
Program for certain graduate medical education pro-
grams established to train residents displaced by natural 
disasters. 
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. ALTERNATIVE PAYMENT AMOUNTS FOR GRAD-
UATE MEDICAL EDUCATION PROGRAMS ES-
TABLISHED 
TO 
TRAIN 
RESIDENTS 
DIS-
PLACED BY NATURAL DISASTERS. 
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law, in applying section 1886(h) of the Social Secu-
rity Act (42 U.S.C. 1395ww(h)(2)), and any regulations 
implementing such section, with respect to an eligible hos-
pital for a cost reporting period beginning on or after July 
1, 2005, the Secretary of Health and Human Services 
shall provide for payments for direct graduate education 
costs in accordance with subsection (c) for such hospital 
and cost reporting period. 
(b) ELIGIBLE HOSPITAL DEFINED.—In this section, 
the term ‘‘eligible hospital’’ means a hospital that— 
(1) did not have a graduate medical education 
program under section 1886(h) of the Social Secu-
rity Act (42 U.S.C. 1395ww(h)) before the date of 
a presidential declaration of major disaster issued 
under section 401 of the Robert T. Stafford Disaster 
Relief and Emergency Assistance Act; 
(2) established such a program to educate resi-
dents displaced from a graduate medical education 
program impacted by such disaster; and 
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(3) is located in a wage area that is in, or im-
mediately adjacent to, an area for which such dis-
aster was declared. 
(c) PAYMENT TO ELIGIBLE HOSPITALS.—The pay-
ment amount for an eligible hospital for a cost reporting 
period in which the hospital operates a graduate medical 
education program referred to in subsection (b)(2) shall 
be— 
(1) for the first such cost reporting period, the 
reasonable costs (as determined based on rules ap-
plied in determining reasonable costs under section 
1886(h)(2)(A) of the Social Security Act) incurred 
by the hospital for such program; 
(2) for the second such cost reporting period, 
computed based on an alternative FTE resident 
amount 
calculated 
as 
described 
in 
section 
1886(h)(2)(A) of the Social Security Act (42 U.S.C. 
1395ww(h)(2)(A)), but using the reasonable costs 
incurred by the hospital for such program during 
such second cost reporting period and the number of 
FTE 
residents 
(as 
described 
in 
section 
1886(h)(3)(B)(ii) of the Social Security Act (42 
U.S.C. 1395ww(h)(3)(B)(ii))) in the program for 
such second cost reporting period; and 
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