Topic: Health — Manpower
Subject: Health
Date: 2013-03-14 00:00:00

Training Tomorrow's Doctors Today Act - 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 (DGME) costs.

Directs the Secretary of Health and Human Services (HHS), for each of FY2014-FY2018 (and each succeeding fiscal year if additional residency positions are available to distribute), to increase the otherwise applicable resident limit for each qualifying hospital.

Directs the Secretary to determine the total number of additional residency positions available for distribution, in accordance with guidelines for allocating 33% to hospitals already operating over the resident limit, and generally setting the aggregate number of increases in the resident limit to 3,000 in each year.

Specifies the process for distributing positions.

Declares that, for discharges occurring on or after July 1, 2015, the indirect teaching adjustment factor, with respect to additional payments for subsection (d) hospitals with indirect costs of medical education (IME), insofar as those additional payments are attributable to resident positions distributed to a hospital according to such process, shall be computed in a specified manner with respect to those resident positions.

(Generally, a subsection [d] hospital is an acute care hospital, particularly one that receives payments under Medicare's inpatient prospective payment system [IPPS] when providing covered inpatient services to eligible beneficiaries.) Revises requirements for counting interns and residents to declare that in certain circumstances the three-year rolling average of the actual full-time equivalent resident counts shall not apply. Makes the same declaration with respect to the ratio of the hospital's full-time equivalent interns and residents to beds. Eliminates both requirements after December 31, 2012.

Requires the current year count of full-time equivalent residents to determine a hospital's graduate medical education (GME) payment.

Requires all the time spent by an intern or resident in an approved medical residency training program, regardless of setting, to be counted toward the determination of full-time equivalency if the hospital meets certain subsection (d) hospital criteria.

Prohibits the Secretary from treating a cost reporting period for which a hospital trains residents participating in a program of another hospital as a period for which the hospital has an approved medical residency period.

Requires the Secretary (who currently is authorized) to prescribe rules which allow institutions which are members of the same affiliated group to elect to apply the limitation on the number of residents in allopathic and osteopathic medicine on an aggregate basis. Requires such rules to authorize all facilities established on or after January 1, 2000, whose resident limits are adjusted on or after January 1, 1997, to elect to apply the limitation on the number of residents in allopathic and osteopathic medicine on an aggregate basis after a certain period.

Declares that, in the case of a resident who changes residency specialties, the period of board eligibility and the initial residency period shall be equal to the minimum number of years of formal training required to satisfy the requirements for the initial board eligibility of the program into which the resident transfers.

Directs the Secretary to establish and implement procedures under which the amount of payments that a hospital would otherwise receive for IME costs for discharges occurring during a fiscal year is adjusted based on the reporting of measures and the performance of the hospital on measures of patient care priorities.

Directs the Secretary to report to Congress and the National Health Care Workforce Commission on both DGME and IME payments that hospitals receive under the Medicare program.

Directs the Comptroller General to study: (1) the physician workforce, identifying specialties for which there is a shortage; and (2) strategies for increasing the diversity of the health profession workforce.