IB 
Union Calendar No. 284 
109TH CONGRESS 
2D SESSION 
H. R. 5574 
[Report No. 109–508] 
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 
JUNE 20, 2006 
Additional sponsor: Mr. ROSS 
JUNE 20, 2006 
Reported with an amendment, committed to the Committee of the Whole 
House on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on June 9, 2006] 
A BILL 
To amend the Public Health Service Act to reauthorize sup-
port for graduate medical education programs in chil-
dren’s hospitals. 
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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’’. 
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 fis-
cal 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 
‘‘subsection (b)(1)(B)’’; 
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(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: 
‘‘(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)’’ and in-
serting ‘‘paragraphs (2) and (3)’’; and 
(2) by adding at the end the following: 
‘‘(3) ANNUAL REPORTING REQUIRED.— 
‘‘(A) REDUCTION IN PAYMENT FOR FAILURE 
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 pro-
vide the Secretary, as an addendum to 
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the hospital’s application under this 
section for such fiscal year, the report 
required under subparagraph (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 in-
formation within such period, no reduction 
shall be made under clause (i) on the basis 
of the previous failure to provide such infor-
mation. 
‘‘(B) ANNUAL
REPORT.—The report re-
quired under this subparagraph for a children’s 
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hospital for a fiscal year is a report that in-
cludes (in a form and manner specified by the 
Secretary) the following information for the resi-
dency academic year completed immediately 
prior to such fiscal year: 
‘‘(i) The types of resident training pro-
grams that the hospital provided for resi-
dents described in subparagraph (C), such 
as general pediatrics, internal medicine/pe-
diatrics, and pediatric subspecialties, in-
cluding both medical subspecialties certified 
by the American Board of Pediatrics (such 
as pediatric gastroenterology) and non-med-
ical subspecialties approved by other med-
ical certification boards (such as pediatric 
surgery). 
‘‘(ii) The number of training positions 
for residents described in subparagraph (C), 
the number of such positions recruited to 
fill, and the number of such positions filled. 
‘‘(iii) The types of training that the 
hospital provided for residents described in 
subparagraph (C) related to the health care 
needs of different populations, such as chil-
dren who are underserved for reasons of 
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family income or geographic location, in-
cluding rural and urban areas. 
‘‘(iv) The changes in residency train-
ing for residents described in subparagraph 
(C) which the hospital has made during 
such residency 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 sec-
tion), including— 
‘‘(I) changes in curricula, train-
ing experiences, and types of training 
programs, and benefits that have re-
sulted from such changes; and 
‘‘(II) changes for purposes of 
training the residents in the measure-
ment and improvement of the quality 
and safety of patient care. 
‘‘(v) The numbers of residents described 
in subparagraph (C) who completed their 
residency training at the end of such resi-
dency academic year and care for children 
within the borders of the service area of the 
hospital or within the borders of the State 
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