Advancing Medical Resident Training in Community Hospitals Act of 2016

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Advancing Medical Resident Training 
in Community Hospitals Act of 2016''.

SEC. 2. MEDICARE GME TREATMENT OF HOSPITALS ESTABLISHING NEW MEDICAL 
              RESIDENCY TRAINING PROGRAMS AFTER HOSTING MEDICAL 
              RESIDENT ROTATORS FOR SHORT DURATIONS.

    (a) Redetermination of Approved FTE Resident Amount.--Section 
1886(h)(2)(F) of the Social Security 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--
                            ``(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 reporting period beginning on or after 
                        October 1, 1997, and before the date of the 
                        enactment of this clause,
                the Secretary shall provide the hospital an opportunity 
                to have a new FTE resident amount established when the 
                hospital begins training at least 1.0 full-time 
                equivalent resident (in the case of a hospital 
                described in subclause (I)) or more than 3.0 full-time-
                equivalent residents (in the case of a hospital 
                described in subclause (II)) for cost reporting periods 
                beginning on or after the date of the enactment of this 
                clause and in accordance with the methodology under the 
                rules in effect as of October 1, 2015.''.
    (b) Redetermination of FTE Resident Limitation.--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 Secretary 
                        shall not determine an adjustment 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 subparagraph (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 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 accordance 
                        with the methodology 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.
                            ``(IV) In the case of a hospital for which 
                        an adjustment in the limitation applicable to a 
                        hospital under subparagraph (F) is based on the 
                        training 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 
                        hospital an opportunity to have a new 
                        adjustment in such limitation determined when 
                        the hospital begins training more than 3.0 
                        full-time-equivalent residents in accordance 
                        with the methodology 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 the Social Security Act (42 
U.S.C. 1395ww) for cost reporting periods beginning on or after the 
date of the enactment of this Act.

Summary: Advancing Medical Resident Training in Community Hospitals Act of 2016 This bill amends title XVIII (Medicare) of the Social Security Act to&nbsp;revise payment rules for graduate medical education (GME) costs with respect to a hospital that establishes a new medical residency training program.  With respect to a hospital that has not entered into a GME affiliation agreement, the Centers for Medicare &amp; Medicaid Services (CMS) shall establish the hospital's full-time equivalent (FTE) resident amount only after determining that the hospital's medical residency training program trains more than 1.0 FTE resident in a cost reporting period. In the case of a hospital with an approved FTE resident amount based on the training of no more than 1.0 FTE resident in a cost reporting period before October 1, 1997, or 3.0 FTE residents in a cost reporting period after that date, CMS shall provide the hospital an opportunity to have its FTE resident amount reestablished when the hospital begins&nbsp;training FTE residents&nbsp;in excess of&nbsp;the&nbsp;applicable threshold.  Current law limits the number, subject to&nbsp;the application of&nbsp;certain adjustments,&nbsp;of FTE residents a hospital may have in allopathic and osteopathic medicine for purposes of Medicare payment. The bill specifies that CMS shall determine a hospital's&nbsp;limitation&nbsp;adjustment only after determining that the hospital's medical residency training program trains&nbsp;more than 1.0 FTE residents in a cost reporting period. In the case of a hospital with a limitation adjustment based on the training of no more than 1.0 FTE resident in a cost reporting period before October 1, 1997, or 3.0 FTE residents in a cost reporting period after that date, CMS shall provide the hospital an opportunity to have its&nbsp;adjustment re-determined&nbsp;when the hospital begins&nbsp;training FTE residents&nbsp;in excess of&nbsp;the&nbsp;applicable threshold.