under paragraph (4)(F) that may be aggre-
gated pursuant to paragraph (4)(H) among 
members of the same affiliated group. 
‘‘(G) DEFINITIONS.—In this paragraph: 
‘‘(i) OTHERWISE
APPLICABLE
RESI-
DENT LIMIT.—The term ‘otherwise appli-
cable resident limit’ means, with respect to 
a hospital, the limit otherwise applicable 
under subparagraphs (F)(i) and (H) of 
paragraph (4) on the resident level for the 
hospital determined without regard to this 
paragraph but taking into account para-
graphs (7)(A), (7)(B), (8)(A), and (8)(B). 
‘‘(ii) REFERENCE RESIDENT LEVEL.— 
Except as otherwise provided in subclause 
(II), the term ‘reference resident level’ 
means, with respect to a hospital, the resi-
dent level for the most recent cost report-
ing period of the hospital ending on or be-
fore the date of enactment of this para-
graph, for which a cost report has been 
settled (or, if not, submitted (subject to 
audit)), as determined by the Secretary. 
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‘‘(iii) RESIDENT
LEVEL.—The term 
‘resident level’ has the meaning given such 
term in paragraph (7)(C)(i). 
‘‘(iv) SHORTAGE
SPECIALTY
RESI-
DENCY
PROGRAM.—The term ‘shortage 
specialty residency program’ means the fol-
lowing: 
‘‘(I) 
PRIOR
TO
REPORT
ON 
SHORTAGE
SPECIALTIES.—Prior 
to 
the date on which the report of the 
National 
Health 
Care 
Workforce 
Commission is submitted under sec-
tion 3 of the Resident Physician 
Shortage Reduction Act of 2013, any 
approved residency training program 
in a specialty identified in the report 
entitled ‘The Physician Workforce: 
Projections and Research into Current 
Issues Affecting Supply and Demand’, 
issued in December 2008 by the 
Health Resources and Services Ad-
ministration, as a specialty whose 
baseline physician requirements pro-
jections exceed the projected supply of 
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total active physicians for the period 
of 2005 through 2020. 
‘‘(II) AFTER REPORT ON SHORT-
AGE
SPECIALTIES.—On or after the 
date on which the report of the Na-
tional Health Care Workforce Com-
mission is submitted under such sec-
tion, any approved residency training 
program in a physician specialty iden-
tified in such report as a specialty for 
which there is a shortage.’’. 
(b) IME.—Section 1886(d)(5)(B) of the Social Secu-
rity Act (42 U.S.C. 1395ww(d)(5)(B)) is amended— 
(1) in clause (v), in the second sentence, by 
striking ‘‘subsections (h)(7) and (h)(8)’’ and insert-
ing ‘‘subsections (h)(7), (h)(8), and (h)(9)’’; 
(2) by redesignating clause (x), as added by 
section 5505(b) of the Patient Protection and Af-
fordable Care Act (Public Law 111–148), as clause 
(xi) and moving such clause 4 ems to the left; and 
(3) by adding after clause (xi), as redesignated 
by subparagraph (A), the following new clause: 
‘‘(xii) For discharges occurring on or 
after July 1, 2015, insofar as an additional 
payment amount under this subparagraph 
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is attributable to resident positions distrib-
uted to a hospital under subsection (h)(9), 
the indirect teaching adjustment factor 
shall be computed in the same manner as 
provided under clause (ii) with respect to 
such resident positions.’’. 
SEC. 3. STUDY AND REPORT BY NATIONAL HEALTH CARE 
WORKFORCE COMMISSION. 
(a) STUDY.—The National Health Care Workforce 
Commission established under section 5101 of the Patient 
Protection and Affordable Care Act (Public Law 111– 
148) shall conduct a study of the physician workforce. 
Such study shall include the identification of physician 
specialties for which there is a shortage, as defined by the 
Commission. 
(b) REPORT.—Not later than January 1, 2016, the 
National Health Care Workforce Commission shall submit 
to Congress a report on the study conducted under sub-
section (a), together with recommendations for such legis-
lation and administrative action as the Commission deter-
mines appropriate. 
SEC. 4. STUDY AND REPORT ON STRATEGIES FOR INCREAS-
ING DIVERSITY. 
(a) STUDY.—The Comptroller General of the United 
States (in this section referred to as the ‘‘Comptroller 
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General’’) shall conduct a study on strategies for increas-
ing the diversity of the health professional workforce. Such 
study shall include an analysis of strategies for increasing 
the number of health professionals from rural, lower in-
come, and underrepresented minority communities, includ-
ing which strategies are most effective for achieving such 
goal. 
(b) REPORT.—Not later than 2 years after the date 
of enactment of this Act, the Comptroller General shall 
submit to Congress a report on the study conducted under 
subsection (a), together with recommendations for such 
legislation and administrative action as the Comptroller 
General determines appropriate. 
Æ 
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