Advancing Medical Resident Training in Community Hospitals Act of 2019

I 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 consider- ation 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 Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Advancing Medical 4 Resident Training in Community Hospitals Act of 2019’’. 5 VerDate Sep 11 2014 04:27 Mar 05, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1358.IH H1358 kjohnson on DSK79L0C42 with BILLS 2 •HR 1358 IH SEC. 2. MEDICARE GME TREATMENT OF HOSPITALS ESTAB- 1 LISHING NEW MEDICAL RESIDENCY TRAIN- 2 ING PROGRAMS AFTER HOSTING MEDICAL 3 RESIDENT ROTATORS FOR SHORT DURA- 4 TIONS. 5 (a) REDETERMINATION OF APPROVED FTE RESI- 6 DENT AMOUNT.—Section 1886(h)(2)(F) of the Social Se- 7 curity Act (42 U.S.C. 1395ww(h)(2)(F)) is amended— 8 (1) by inserting ‘‘(i)’’ before ‘‘In the case of’’; 9 and 10 (2) by adding at the end the following: 11 ‘‘(ii) In applying this subparagraph to a 12 hospital that has not entered into a GME affili- 13 ation agreement (as defined by the Secretary 14 for purposes of paragraph (4)(H)(ii)), the Sec- 15 retary shall not provide for the establishment of 16 an FTE resident amount until such time as the 17 Secretary determines that the hospital has a 18 medical residency training program that trains 19 more than 1.0 full-time-equivalent resident in a 20 cost reporting period. 21 ‘‘(iii) In the case of a hospital with an ap- 22 proved FTE resident amount— 23 ‘‘(I) based on the training of less than 24 1.0 full-time-equivalent resident before Oc- 25 tober 1, 1997, or 26 VerDate Sep 11 2014 04:27 Mar 05, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1358.IH H1358 kjohnson on DSK79L0C42 with BILLS 3 •HR 1358 IH ‘‘(II) based on the training of no more 1 than 3.0 full-time-equivalent residents in a 2 medical residency training program in any 3 cost reporting period beginning on or after 4 October 1, 1997, and before the date of 5 the enactment of this clause, 6 the Secretary shall provide the hospital an op- 7 portunity to have a new FTE resident amount 8 established when the hospital begins training at 9 least 1.0 full-time-equivalent resident (in the 10 case of a hospital described in subclause (I)) or 11 more than 3.0 full-time-equivalent residents (in 12 the case of a hospital described in subclause 13 (II)) for cost reporting periods beginning on or 14 after the date of the enactment of this clause 15 and in accordance with the methodology under 16 the rules in effect as of October 1, 2015.’’. 17 (b) REDETERMINATION OF FTE RESIDENT LIMITA- 18 TION.—Section 1886(h)(4)(H)(i) of the Social Security 19 Act (42 U.S.C. 1395ww(h)(4)(H)(i)) is amended— 20 (1) by inserting ‘‘(I)’’ before ‘‘The Secretary’’; 21 and 22 (2) by adding at the end the following: 23 ‘‘(II) Under this clause the Secretary 24 shall not determine an adjustment in the 25 VerDate Sep 11 2014 04:27 Mar 05, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1358.IH H1358 kjohnson on DSK79L0C42 with BILLS 4 •HR 1358 IH limitation applicable to a hospital under 1 subparagraph (F) until the hospital trains 2 more than 1.0 full-time-equivalent resident 3 in a new medical residency training pro- 4 gram in a cost reporting period. 5 ‘‘(III) In the case of a hospital that 6 has a limitation under subparagraph (F) of 7 less than 1.0 full-time-equivalent resident 8 as of the date of the enactment of this sub- 9 clause based on training before October 1, 10 1997, under this clause the Secretary shall 11 provide the hospital an opportunity to have 12 a new adjustment in such limitation deter- 13 mined when such hospital begins training 14 at least 1.0 full-time-equivalent resident in 15 accordance with the methodology applica- 16 ble to hospitals under the rules in effect as 17 of October 1, 2015, and applied for cost 18 reporting periods beginning on or after the 19 date of the enactment of this subclause. 20 ‘‘(IV) In the case of a hospital for 21 which an adjustment in the limitation ap- 22 plicable to a hospital under subparagraph 23 (F) is based on the training of no more 24 than 3.0 full-time-equivalent residents in a 25 VerDate Sep 11 2014 04:27 Mar 05, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1358.IH H1358 kjohnson on DSK79L0C42 with BILLS 5 •HR 1358 IH new medical residency training program in 1 a cost reporting period beginning on or 2 after October 1, 1997, and before the date 3 of the enactment of this subclause, the 4 Secretary shall provide the hospital an op- 5 portunity to have a new adjustment in 6 such limitation determined when the hos- 7 pital begins training more than 3.0 full- 8 time-equivalent residents in accordance 9 with the methodology applicable to hos- 10 pitals under the rules in effect as of Octo- 11 ber 1, 2015, and applied for cost reporting 12 periods beginning on or after the date of 13 the enactment of this subclause.’’. 14 (c) EFFECTIVE DATE.—The amendments made by 15 this section shall apply to payment under section 1886 of 16 the Social Security Act (42 U.S.C. 1395ww) for cost re- 17 porting periods beginning on or after the date of the en- 18 actment of this Act. 19 Æ VerDate Sep 11 2014 04:27 Mar 05, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\H1358.IH H1358 kjohnson on DSK79L0C42 with BILLS