instruction:
In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
question:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Improving Physician Access in 
Teaching Hospitals (PATH) Act of 2011''.

SEC. 2. DISTRIBUTION OF ADDITIONAL RESIDENCY SLOTS.

    Section 1886(h) of the Social Security Act (42 U.S.C. 1395ww(h)) is 
amended--
            (1) in paragraph (7)(E), by inserting ``paragraph (9),'' 
        after ``paragraph (8),''; and
            (2) by adding at the end the following:
            ``(9) Distribution of additional residency positions.--
                    ``(A) Reductions in limit based on unused 
                positions.--
                            ``(i) In general.--Except as provided in 
                        clause (ii), if a hospital's resident level (as 
                        defined in paragraph (7)(C)(i)) for each of the 
                        5 most recent cost reporting periods (ending 
                        before the date of the enactment of this 
                        paragraph) of the hospital for which a cost 
                        report has been settled (or, if not, submitted 
                        subject to audit) as determined by the 
                        Secretary is less than the otherwise applicable 
                        resident limit (as defined in paragraph 
                        (8)(H)(iii)), effective for portions of cost 
                        reporting periods occurring on or after the 
                        paragraph (9) effective date (as defined in 
                        subparagraph (E)), the otherwise applicable 
                        resident limit shall be reduced by the 
                        difference between such otherwise applicable 
                        resident limit and the highest such reference 
                        resident level for any of such 5 cost reporting 
                        periods.
                            ``(ii) Exception.--Clause (i) shall not 
                        apply to--
                                    ``(I) a hospital located in a rural 
                                area with fewer than 250 beds; or
                                    ``(II) a hospital that has had in 
                                effect a voluntary residency reduction 
                                plan under paragraph (6) or pursuant to 
                                section 402 of Public Law 90-248.
                    ``(B) Requirements for additional residency 
                slots.--
                            ``(i) In general.--The Secretary shall 
                        increase the otherwise applicable resident 
                        limit for hospitals that submit an application 
                        under this subparagraph by such number as the 
                        Secretary may approve for portions of cost 
                        reporting periods occurring on or after the 
                        paragraph (9) effective date. The aggregate 
                        number of increases in the otherwise applicable 
                        resident limit under this subparagraph shall be 
                        equal to the sum of--
                                    ``(I) the aggregate reduction in 
                                such limits attributable to 
                                subparagraph (A) (as estimated by the 
                                Secretary); and
                                    ``(II) 1,000 for portions of cost 
                                reporting periods occurring during the 
                                12-month period beginning on the 
                                paragraph (9) effective date, 1,000 
                                additional positions for portions of 
                                cost reporting periods occurring during 
                                the 12-month period beginning 1 year 
                                after such effective date, 1,000 
                                additional positions for portion of 
                                cost reporting period occurring during 
                                the 12-month period beginning 2 years 
                                after such effective date, and such 
                                number of additional positions for 
                                portions of the 2 subsequent cost 
                                reporting periods as the Secretary may 
                                determine necessary to support 
                                residency training programs in 
                                specialities that exceed 3 years.
                            ``(ii) Consideration in redistribution.--In 
                        determining for which hospitals the increase in 
                        the otherwise applicable resident limit is 
                        provided under this subparagraph, the Secretary 
                        shall take into account--
                                    ``(I) data provided by the Health 
                                Resources and Services Administration 
                                as a national standard to exhibit a 
                                specific demand in the health care 
                                workforce, as well as the 
                                Administration's projected demand and 
                                supply for physicians in the specialty 
                                of medicine involved; and
                                    ``(II) the demonstrated likelihood 
                                of the hospital filling positions made 
                                available under this paragraph within 
                                the first 3 cost reporting periods 
                                beginning on or after the paragraph (9) 
                                effective date.
                        The Secretary shall give special consideration 
                        for up to 25 additional positions in the case 
                        of a hospital that demonstrates the likelihood 
                        of filing such positions during the first cost 
                        reporting period beginning on or after such 
                        effective date.
                            ``(iii) Limitation.--In no case shall the 
                        number of additional positions made available 
                        to a hospital under this paragraph exceed 25 in 
                        the first cost reporting period or 75 for all 
                        cost reporting periods.
                    ``(C) Priority for additional positions resulting 
                from hospital closures.--With respect to additional 
                positions described in subparagraph (B)(i)(I) which are 
                derived from a reduction in limits under subparagraph 
                (A) for a hospital that closed (in this subparagraph 
                referred to as a `closed hospital'), the Secretary 
                shall distribute the increase to hospitals in the 
                following priority order:
                            ``(i) First, to other hospitals for the 
                        program or programs under which the hospital 
                        had a cooperative arrangement with the closed 
                        hospital under which residents in the graduate 
                        medical education program of the closed 
                        hospital also rotated through the other 
                        hospital.
                            ``(ii) Second, to other hospitals that are 
                        members of the same affiliated group of 
                        hospitals as the closed hospital.
                            ``(iii) Third, to other hospitals that are 
                        located in the same or contiguous core-based 
                        statistical area as the closed hospital.
                    ``(D) Preference.--After applying subparagraph (C) 
                and the special consideration under subparagraph (B), 
                in determining for which hospitals the increase in the 
                otherwise applicable resident limit is provided under 
                subparagraph (B), the Secretary shall give preference 
                to hospitals--
                            ``(i) that submit an application for new 
                        residents in primary care and geriatric 
                        medicine and in other specialties as determined 
                        to be in demand under subparagraph (B)(ii)(I); 
                        and
                            ``(ii) that emphasize training in community 
                        health centers and other community-based or 
                        hospital-sponsored clinics, and private 
                        physicians' offices, including physician 
                        groups.
                    ``(E) Paragraph (9) effective date defined.--In 
                this paragraph, the term `paragraph (9) effective date' 
                means July 1 of the year that begins after the date of 
                the enactment of this paragraph.
                    ``(F) Affiliation.--The provisions of this 
                paragraph shall be applied to hospitals which are 
                members of the same affiliated group (as defined by the 
                Secretary under paragraph (4)(H)(ii)) and the reference 
                resident level for each such hospital with respect to 
                the cost reporting period that results in the smallest 
                difference between the reference resident level and the 
                otherwise applicable resident limit.''.

SEC. 3. EXPANDING PRIMARY CARE BONUS TO CERTAIN UNDERSERVED 
              SPECIALTIES.

    (a) In General.--Section 1833(x)(2)(A) of the Social Security Act 
(42 U.S.C. 1395l(x)(2)(A)) is amended--
            (1) in clause (i)--
                    (A) by striking ``or'' at the end of subclause (I);
                    (B) by striking ``and'' at the end of subclause 
                (II) and inserting ``or''; and
                    (C) by adding at the end the following new 
                subclause:
                                    ``(III) is a physician (as 
                                described in section 1861(r)(1)) who is 
                                in an underserved specialty, such as 
                                psychiatry or neurology, as specified 
                                by the Secretary, or other specialty 
                                identified by the Secretary to be in 
                                demand; and''; and
            (2) in clause (ii), by inserting after ``(ii)'' the 
        following: ``in the case of an individual described in 
        subclause (I) or (II) of clause (i),''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to payments for items and services furnished on or after January 
1, 2012.

SEC. 4. SMALL PHYSICIAN PRACTICE RESIDENCY CREDIT.

    (a) In General.--Subpart D of part IV of subchapter A of chapter 1 
of the Internal Revenue Code of 1986 (relating to business related 
credits) is amended by adding at the end the following new section:

``SEC. 45S. SMALL PHYSICIAN PRACTICE RESIDENCY CREDIT.

    ``(a) In General.--For purposes of section 38, the amount of the 
small physician practice residency credit determined under this section 
for any taxable year with respect to a qualified small physician 
practice is the sum of the following:
            ``(1) Overall amount.--The per resident dollar amount 
        multiplied by the number of qualified teaching hospital 
        residents who provide services to, and are trained by, such 
        practice during the taxable year and who are in their first, 
        second, or third post-graduate year of medical residency.
            ``(2) Bonus.--The sum of--
                    ``(A) 50 percent of the per resident dollar amount 
                multiplied by the number of such residents who are in 
                their first post-graduate year of medical residency 
                during the taxable year; and
                    ``(B) 25 percent of the per resident dollar amount 
                multiplied by the average number of such residents who 
                are not counted under subparagraph (A) and are in their 
                second post-graduate year during the taxable year.
    ``(b) Qualified Small Physician Practice.--For purposes of this 
section, the term `qualified small physician practice' means any trade 
or business of providing physicians' services (as defined in section 
1861(q) of the Social Security Act), which may be a community health 
center, that is owned and operated by a doctor of medicine or 
osteopathy if fewer than 50 individuals are employed in such trade or 
business (including new training sites) and the trade or business 
includes as part of the practice the training of doctors of medicine or 
osteopathy in a rotation covering at least 6 months in the taxable 
year. All persons treated as a single employer under subsection (a) or 
(b) or section 52 or subsection (m) or (o) of section 414 shall be 
treated as a single trade or business for purposes of the preceding 
sentence.
    ``(c) Qualified Teaching Hospital Residents.--For purposes of this 
section, the term `qualified teaching hospital resident' means any 
resident (within the meaning of subparagraph (I) of section 1886(h)(5) 
of the Social Security Act) in an approved medical residency training 
program (as defined in subparagraph (A) of such section) which provides 
services to the qualified small physician practice (while utilizing the 
technologies and supplies of such practice) for a period not less 
than--
            ``(1) 4 weeks in the case of a primary care resident (as 
        defined in subparagraph (H) of such section); or
            ``(2) 2 weeks in the case of any other resident.
    ``(d) Per Resident Dollar Amount.--For purposes of this section, 
the term `per resident dollar amount' means, in the case of a qualified 
small physician practice that includes as part of the practice the 
training of doctors of medicine or osteopathy in a rotation covering--
            ``(1) at least 6 months but less than 9 months in the 
        taxable year, $2,500; or
            ``(2) at least 9 months in the taxable year, $3,000.
    ``(e) Residents Not Taken Into Account More Than Once.--A qualified 
teaching hospital resident shall be taken into account under subsection 
(a) for the taxable in which the period described in subsection (c) 
ends and shall not be so taken into account for any other taxable 
year.''.
    (b) Credit Allowed as Part of General Business Credit.--Section 
38(b) of such Code (defining current year business credit) is amended 
by striking ``plus'' at the end of paragraph (35), by striking the 
period at the end of paragraph (36) and inserting ``, plus'', and by 
adding at the end the following new paragraph:
            ``(37) the small physician practice residency credit 
        determined under section 45S(a).''.
    (c) Conforming Amendment.--The table of sections for subpart D of 
part IV of subchapter A of chapter 1 of such Code is amended by adding 
at the end the following new item:

``Sec. 45S. Small physician practice residency credit.''.
    (d) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after the date of the enactment of 
this Act.
answer:
Improving Physician Access in Teaching Hospitals (PATH) Act of 2011 - Amends title XVIII (Medicare) of the Social Security Act with respect to distribution of additional resident positions as they affect calculation of payments for direct graduate medical education (DME) costs.

States that, if a hospital's resident level for each of the five most recent cost reporting periods is less than the otherwise applicable resident limit, then the otherwise applicable resident limit shall be reduced by the difference between it and the highest reference resident level for any of those five cost reporting periods. Excepts from this reduction requirement a hospital: (1) located in a rural area with fewer than 250 beds, or (2) that has had in effect a voluntary residency reduction plan.

Requires the Secretary of Health and Human Services (HHS) to increase the otherwise applicable resident limit (create additional residency slots) for applicant hospitals according to a specified formula that takes into account the aggregate reduction in limits attributable to this Act.

Expands the primary care bonus to certain underserved specialties, such as psychiatry or neurology.

Amends the Internal Revenue Code to allow a small physician practice residency credit.


question:
SECTION 1. SHORT TITLE.

    This Act may be cited as ``Medicaid/SCHIP Optional Coverage for 
Young Adults Act of 2003''.

SEC. 2. PROVIDING STATE OPTION FOR SCHIP AND MEDICAID COVERAGE OF YOUNG 
              ADULTS UP TO AGE 23.

    (a) In General.--
            (1) Medicaid.--(A) Section 1902(l)(1)(D) of the Social 
        Security Act (42 U.S.C. 1396a(l)(1)(D)) is amended by inserting 
        ``(or, at the option of the State, who have not attained 20, 
        21, or 22 years of age, as the State may elect)'' after ``have 
        not attained 19 years of age''.
            (B) Clause (i) of section 1905(a) of the Social Security 
        Act (42 U.S.C. 1396d(a)) is amended by striking ``under the age 
        of 21, or, at the option of the State, under the age of 20, 19, 
        or 18 as the State may choose'' and inserting ``under the age 
        of 23, or, at the option of the State, under the age of 22, 21, 
        20, 19, or 18 as the State may elect''.
            (2) SCHIP.--Section 2110(c)(1) of such Act (42 U.S.C. 
        1397jj(c)(1)) is amended by inserting after ``19 years of age'' 
        the following: ``(or, at the option of the State and subject to 
        the availability of additional allotments under section 
        2104(d), 20, 21, 22, or 23 years of age)''.
    (b) Availability of Enhanced Matching Funds.--
            (1) Under medicaid.--Section 1905 of the Social Security 
        Act (42 U.S.C. 1396d) is amended--
                    (A) in the fourth sentence of subsection (b), by 
                striking ``or subsection (u)(3)'' and inserting ``, 
                (u)(3), or (u)(4)(A)''; and
                    (B) in subsection (u)--
                            (i) by adding at the end of paragraph (1) 
                        the following new subparagraph:
            ``(C) Only with respect to expenditures described in 
        paragraph (4)(A), if the State is providing for benefits under 
        its State child health plan under title XXI for children under 
        19 years of age exclusively through benefits under its State 
        plan under this title, the State is also providing under such 
        plan the benefits for individuals over 18 years of age who are 
        eligible for such benefits only because of an election referred 
        to in such paragraph.'';
                            (ii) by redesignating paragraph (4) as 
                        paragraph (5); and
                            (iii) by inserting after paragraph (3) the 
                        following new paragraph:
    ``(4) For purposes of the fourth sentence of subsection (b) and 
section 2105(a), the expenditures described in this paragraph are 
expenditures for medical assistance for individuals who are over 18 
(and less than 23) years of age and who are eligible for such medical 
assistance because of an election by the State under section 
1902(l)(1)(D) or clause (i) of section 1905(a).''.
            (2) Additional allotments for providing coverage of 
        optional young adults.--
                    (A) In general.--Section 2104 of such Act (42 
                U.S.C. 1397dd) is amended by inserting after subsection 
                (c) the following:
    ``(d) Additional Allotments for the Provision of Coverage to 
Optional Young Adults.--
            ``(1) Appropriation; total allotment.--For the purpose of 
        providing additional allotments to States under this title, 
        there is appropriated, out of any money in the Treasury not 
        otherwise appropriated, for each of fiscal years 2004 through 
        2007, $200,000,000.
            ``(2) State and territorial allotments.--In addition to the 
        allotments provided under subsections (b) and (c), subject to 
        paragraph (3), of the amount available for the additional 
        allotments under paragraph (1) for a fiscal year, the Secretary 
        shall allot to each State with a State child health plan 
        approved under this title--
                    ``(A) in the case of such a State other than a 
                commonwealth or territory described in subparagraph 
                (B), the same proportion as the proportion of the 
                State's allotment under subsection (b) (determined 
                without regard to subsection (f)) to the total amount 
                of the allotments under subsection (b) for such States 
                eligible for an allotment under this paragraph for such 
                fiscal year; and
                    ``(B) in the case of a commonwealth or territory 
                described in subsection (c)(3), the same proportion as 
                the proportion of the commonwealth's or territory's 
                allotment under subsection (c) (determined without 
                regard to subsection (f)) to the total amount of the 
                allotments under subsection (c) for commonwealths and 
                territories eligible for an allotment under this 
                paragraph for such fiscal year.
            ``(3) Use of additional allotment.--Additional allotments 
        provided under this subsection are not available for amounts 
        expended before October 1, 2003. Such amounts are available for 
        amounts expended on or after such date only for--
                    ``(A) expenditures described in section 
                1905(u)(4)(A); and
                    ``(B) child health assistance for individuals who 
                are targeted low-income children and over 18 years of 
                age and who are low-income children only because of an 
                election by the State under section 2110(c)(1).''.
                    (B) Conforming amendments.--Section 2104 of the 
                Social Security Act (42 U.S.C. 1397dd) is amended--
                            (i) in subsection (a), in the matter 
                        preceding paragraph (1), by inserting ``subject 
                        to subsection (d),'' after ``under this 
                        section,'';
                            (ii) in subsection (b)(1), by inserting 
                        ``and subsection (d)'' after ``Subject to 
                        paragraph (4)''; and
                            (iii) in subsection (c)(1), by inserting 
                        ``subject to subsection (d),'' after ``for a 
                        fiscal year,''.
    (c) Effective Date.--The amendments made by this section apply to 
items and services furnished on or after October 1, 2003, without 
regard to whether regulations implementing such amendments have been 
promulgated.

SEC. 3. GRANTS TO IMPLEMENT MEDICAID AND SCHIP EXPANSIONS.

    (a) In General.--The Secretary of Health and Human Services shall 
provide for grants to small and rural States (as defined by the 
Secretary) in order to enable such States to implement expansions of 
eligibility for children and young adults their State medicaid plans 
under title XIX of the Social Security Act and State child health plans 
under title XXI of such Act. Such grants shall be available for 
planning, implementation, and outreach with respect to such expanded 
eligibility populations.
    (b) Terms and Conditions.--Grants under this section shall be made 
available under such terms and conditions, including the approval of a 
grant application, as the Secretary shall specify.
    (c) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to provide for grants under 
this section.
answer:
Medicaid/SCHIP Optional Coverage for Young Adults Act of 2003 - Amends titles XIX (Medicaid) and XXI (State Children's Health Insurance) (SCHIP) of the Social Security Act to give States the option of providing SCHIP and Medicaid coverage, with an enhanced matching rate, to low-income youth up to age 23.

Directs the Secretary to provide for grants to small and rural States in order to enable them to implement expansions of eligibility for children and young adults under SSA titles XIX and XXI.


question:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``National Health Services Corps and 
Loan Repayment Programs Renewal Act of 2007''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) The National Health Service Corps is a vital resource 
        for underserved communities experiencing shortages of health 
        professionals.
            (2) For over 35 years, National Health Service Corps 
        clinicians have expanded access to primary and preventive 
        health care, dental care, mental health, and behavioral health 
        services in underserved areas of the United States and have 
        improved health outcomes among underserved populations.
            (3) The National Health Service Corps Scholarship Program 
        provides a predictable supply of clinicians who will pursue 
        employment in primary care for underserved communities. Upon 
        completion of their training, National Health Service Corps 
        scholars become salaried employees of organized systems of care 
        in such underserved communities.
            (4) The National Health Service Corps Loan Repayment 
        Program helps communities meet their immediate needs for health 
        professionals by offering to pay off qualifying educational 
        loans in exchange for 2 years of service in an underserved 
        community.
            (5) A recent report in the Journal of the American Medical 
        Association found that community health centers are facing 13 
        percent vacancies for family physician positions and 20.8 
        percent vacancies for OB-GYN positions. The study cited heavy 
        reliance on the National Health Service Corps and recommended 
        expanding the program in order to address those needs.
            (6) Critical to the growth of new and existing health 
        centers is having a sufficient supply of primary care health 
        professionals to staff them. Currently, health centers rely on 
        the National Health Service Corps for over 20 percent of their 
        physician workforce. Yet, just over half of all Corps 
        placements are made to health centers, even though they are one 
        of the strongest cords in the health care safety net.
            (7) Health facilities in rural areas, including community 
        health centers and rural health clinics, face primary care 
        vacancy rates higher than the national average, and are more 
        heavily reliant on the National Health Service Corps to address 
        those needs.
            (8) The number of new medical residents choosing a primary 
        care discipline as a medical specialty is declining, and the 
        National Health Service Corps Scholarship Program and the 
        National Health Service Corps Loan Repayment Program provide an 
        important incentive for students to choose to pursue a career 
        in primary care.

SEC. 3. NATIONAL HEALTH SERVICE CORPS.

    (a) Funding.--To carry out the programs authorized under sections 
331 through 338G of the Public Health Service Act (42 U.S.C. 254d-
254p), there are authorized to be appropriated, and there are 
appropriated--
            (1) for fiscal year 2008, $131,500,000;
            (2) for fiscal year 2009, $175,000,000;
            (3) for fiscal year 2010, $200,000,000;
            (4) for fiscal year 2011, $225,000,000; and
            (5) for fiscal year 2012, $250,000,000.
    (b) Assignment of Personnel.--
            (1) In general.--Section 333(a)(3) of the Public Health 
        Service Act (42 U.S.C. 254f(a)(3)) is amended to read as 
        follows:
            ``(3)(A) In approving applications for assignment of 
        members of the Corps, the Secretary shall not discriminate 
        against applications from entities that are not receiving 
        Federal financial assistance under this Act.
            ``(B) In approving the applications described in 
        subparagraph (A), the Secretary shall--
                    ``(i) give preference to applications in which a 
                nonprofit entity or public entity shall provide a site 
                to which Corps members may be assigned; and
                    ``(ii) give the highest preference to 
                applications--
                            ``(I) for entities described in clause (i) 
                        that are federally-qualified health centers as 
                        defined in section 1905(l)(2)(B) of the Social 
                        Security Act (42 U.S.C. 1396d(l)(2)(B));
                            ``(II) or entities described in clause (i) 
                        that are rural health clinics; and
                            ``(III) for entities described in clause 
                        (i) that primarily serve health disparity 
                        populations or medically underserved 
                        populations.''.
            (2) Priorities in assignment of corps personnel.--Section 
        333A of the Public Health Service Act (42 U.S.C. 254f-1) is 
        amended--
                    (A) in subsection (a)--
                            (i) by redesignating paragraphs (1), (2), 
                        and (3) as paragraphs (2), (3), and (4), 
                        respectively; and
                            (ii) by inserting before paragraph (2) (as 
                        so redesignated) the following:
            ``(1) give preference to applications as set forth in 
        subsection (a)(3) of such section;''; and
                    (B) by striking ``subsection (a)(1)'' each place 
                such appears and inserting ``subsection (a)(2)''.
            (3) Conforming amendment.--Section 338I(c)(3)(B)(ii) of the 
        Public Health Service Act (42 U.S.C. 254q-1(c)(3)(B)(ii)) is 
        amended by striking ``section 333A(a)(1)'' and inserting 
        ``section 333A(a)(2)''.
    (c) Elimination of 6-Year Demonstration Requirement.--Section 
332(a)(1) of the Public Health Service Act (42 U.S.C. 254e(a)(1)) is 
amended by striking ``Not earlier than 6 years'' and all that follows 
through ``purposes of this section''.
answer:

National Health Services Corps and Loan Repayment Programs Renewal Act of 2007 - Reauthorizes appropriations for the National Health Service Corps for FY2008-FY2012.

Amends the Public Health Service Act to direct the Secretary of Health and Human Services, in approving applications for assignment of members of the Corps, to give the highest preference to entities that are federally-qualified health centers, that are rural health clinics, and that primarily serve health disparity populations or medically underserved populations.

Repeals the requirement that federally qualified health centers and rural health clinics demonstate that they meet health professional shortage area requirements every six years after such a center or clinic is designated as having such a shortage.