Children's Hospital GME Support Reauthorization Act of 2006
PL 109-307 (H.R.5574), enacted 10/06/2006

120 STAT. 1721
PUBLIC LAW 109–307—OCT. 6, 2006
Public Law 109–307
109th Congress
An Act
To amend the Public Health Service Act to reauthorize support for graduate medical
education programs in children’s hospitals.
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 ‘‘Children’s Hospital GME Support
Reauthorization Act of 2006’’.
SEC. 2. PROGRAM OF PAYMENTS TO CHILDREN’S HOSPITALS THAT
OPERATE GRADUATE MEDICAL EDUCATION PROGRAMS.
(a) IN GENERAL.—Section 340E of the Public Health Service
Act (42 U.S.C. 256e) is amended—
(1) in subsection (a), by inserting ‘‘and each of fiscal years
2007 through 2011’’ after ‘‘for each of fiscal years 2000 through
2005’’;
(2) in subsection (e)(1), by striking ‘‘26’’ and inserting ‘‘12’’;
(3) in subsection (f)(1)(A)—
(A) in clause (ii), by striking ‘‘and’’ at the end;
(B) in clause (iii), by striking the period at the end
and inserting ‘‘; and’’; and
(C) by adding at the end the following:
‘‘(iv) for each of fiscal years 2007 through 2011,
$110,000,000.’’; and
(4) in subsection (f)(2)—
(A) in the matter before subparagraph (A), by striking
‘‘subsection (b)(1)(A)’’ and inserting ‘‘subsection (b)(1)(B)’’;
(B) in subparagraph (B), by striking ‘‘and’’ at the end;
(C) in subparagraph (C), by striking the period at
the end and inserting ‘‘; and’’; and
(D) by adding at the end the following:
‘‘(D) for each of fiscal years 2007 through 2011,
$220,000,000.’’.
(b) REDUCTION IN PAYMENTS FOR FAILURE TO FILE ANNUAL
REPORT.—Subsection (b) of section 340E of the Public Health
Service Act (42 U.S.C. 256e) is amended—
(1) in paragraph (1), in the matter before subparagraph
(A), by striking ‘‘paragraph (2)’’ and inserting ‘‘paragraphs (2)
and (3)’’; and
(2) by adding at the end the following:
‘‘(3) ANNUAL REPORTING REQUIRED.—
‘‘(A) REDUCTION IN PAYMENT FOR FAILURE TO REPORT.—
Children’s
Hospital GME
Support
Reauthorization
Act of 2006.
42 USC 201 note.
Oct. 6, 2006
[H.R. 5574]
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120 STAT. 1722
PUBLIC LAW 109–307—OCT. 6, 2006
‘‘(i) IN GENERAL.—The amount payable under this
section to a children’s hospital for a fiscal year (begin-
ning with fiscal year 2008 and after taking into account
paragraph (2)) shall be reduced by 25 percent if the
Secretary determines that—
‘‘(I) the hospital has failed to provide the Sec-
retary, as an addendum to the hospital’s applica-
tion under this section for such fiscal year, the
report required under subparagraph (B) for the
previous fiscal year; or
‘‘(II) such report fails to provide the informa-
tion required under any clause of such subpara-
graph.
‘‘(ii) NOTICE AND OPPORTUNITY TO PROVIDE MISSING
INFORMATION.—Before imposing a reduction under
clause (i) on the basis of a hospital’s failure to provide
information described in clause (i)(II), the Secretary
shall provide notice to the hospital of such failure
and the Secretary’s intention to impose such reduction
and shall provide the hospital with the opportunity
to provide the required information within a period
of 30 days beginning on the date of such notice. If
the hospital provides such information within such
period, no reduction shall be made under clause (i)
on the basis of the previous failure to provide such
information.
‘‘(B) ANNUAL REPORT.—The report required under this
subparagraph for a children’s hospital for a fiscal year
is a report that includes (in a form and manner specified
by the Secretary) the following information for the resi-
dency academic year completed immediately prior to such
fiscal year:
‘‘(i) The types of resident training programs that
the hospital provided for residents described in
subparagraph (C), such as general pediatrics, internal
medicine/pediatrics, 
and 
pediatric 
subspecialties,
including both medical subspecialties certified by the
American Board of Pediatrics (such as pediatric gastro-
enterology) and non-medical subspecialties approved
by other medical certification boards (such as pediatric
surgery).
‘‘(ii) The number of training positions for residents
described in subparagraph (C), the number of such
positions recruited to fill, and the number of such
positions filled.
‘‘(iii) The types of training that the hospital pro-
vided for residents described in subparagraph (C)
related to the health care needs of different popu-
lations, such as children who are underserved for rea-
sons of family income or geographic location, including
rural and urban areas.
‘‘(iv) The changes in residency training for resi-
dents described in subparagraph (C) which the hospital
has made during such residency academic year (except
that the first report submitted by the hospital under
this subparagraph shall be for such changes since the
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120 STAT. 1723
PUBLIC LAW 109–307—OCT. 6, 2006
first year in which the hospital received payment under
this section), including—
‘‘(I) changes in curricula, training experiences,
and types of training programs, and benefits that
have resulted from such changes; and
‘‘(II) changes for purposes of training the resi-
dents in the measurement and improvement of
the quality and safety of patient care.
‘‘(v) The numbers of residents described in
subparagraph (C) who completed their residency
training at the end of such residency academic year
and care for children within the borders of the service
area of the hospital or within the borders of the State
in which the hospital is located. Such numbers shall
be disaggregated with respect to residents who com-
pleted residencies in general pediatrics or internal
medicine/pediatrics, 
subspecialty 
residencies, 
and
dental residencies.
‘‘(C) RESIDENTS.—The residents described in this
subparagraph are those who—
‘‘(i) are in full-time equivalent resident training
positions in any training program sponsored by the
hospital; or
‘‘(ii) are in a training program sponsored by an
entity other than the hospital, but who spend more
than 75 percent of their training time at the hospital.
‘‘(D) REPORT TO CONGRESS.—Not later than the end
of fiscal year 2011, the Secretary, acting through the
Administrator of the Health Resources and Services
Administration, shall submit a report to the Congress—
‘‘(i) summarizing the information submitted in
reports to the Secretary under subparagraph (B);
‘‘(ii) describing the results of the program carried
out under this section; and
‘‘(iii) making recommendations for improvements
to the program.’’.
(c) TECHNICAL
AMENDMENTS.—Section 340E of the Public
Health Service Act (42 U.S.C. 256e) is further amended—
(1) in subsection (c)(2)(E)(ii), by striking ‘‘described in
subparagraph (C)(ii)’’ and inserting ‘‘applied under section
1886(d)(3)(E) of the Social Security Act for discharges occurring
during the preceding fiscal year’’;
(2) in subsection (e)(2), by striking the first sentence; and
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120 STAT. 1724
PUBLIC LAW 109–307—OCT. 6, 2006
LEGISLATIVE HISTORY—H.R. 5574 (S. 285):
HOUSE REPORTS: No. 109–508 (Comm. on Energy and Commerce).
CONGRESSIONAL RECORD, Vol. 152 (2006):
June 21, considered and passed House.
Sept. 26, considered and passed Senate, amended.
Sept. 28, House concurred in Senate amendment.
(3) in subsection (e)(3), by striking ‘‘made to pay’’ and
inserting ‘‘made and pay’’.
Approved October 6, 2006.
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