Title: Advancing Medical Resident Training in Community Hospitals Act of 2019
Policy area: Health

Summary:
Advancing Medical Resident Training in Community Hospitals Act of 2019
This bill revises payment rules under Medicare for graduate medical education (GME) costs with respect to a hospital that establishes a new medical residency training program.
If a hospital has not entered into a GME affiliation agreement, the Centers for Medicare & Medicaid Services (CMS) must 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. If a hospital has an approved FTE resident amount that is based on other specified thresholds, the CMS must give the hospital the opportunity to have the amount reestablished when the hospital begins training FTE residents in excess of the applicable threshold.
The bill also establishes similar thresholds for new determinations of certain adjustments to hospital payment limitations regarding FTE residents in allopathic and osteopathic medicine; a hospital that has an adjustment has the opportunity to have it redetermined once the applicable threshold is exceeded.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1358 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 1358

To amend title XVIII of the Social Security Act to establish rules for 
 payment for graduate medical education (GME) costs for hospitals that 
   establish a new medical residency training program after hosting 
                 resident rotators for short durations.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 26, 2019

Mr. Kind (for himself, Mr. Gallagher, Mr. Sensenbrenner, Ms. Moore, Mr. 
Duffy, Mr. Pocan, Mr. Grothman, and Mr. Steil) introduced the following 
  bill; which was referred to the Committee on Ways and Means, and in 
 addition to the Committee on Energy and Commerce, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to establish rules for 
 payment for graduate medical education (GME) costs for hospitals that 
   establish a new medical residency training program after hosting 
                 resident rotators for short durations.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Advancing Medical Resident Training 
in Community Hospitals Act of 2019''.

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 
                        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.
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