Training the Next Generation of Primary Care Doctors Act of 2019

I 116TH CONGRESS 1ST SESSION H. R. 2815 To reauthorize section 340H of the Public Health Service Act to continue to encourage the expansion, maintenance, and establishment of approved graduate medical residency programs at qualified teaching health centers, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MAY 16, 2019 Mr. RUIZ (for himself, Mrs. RODGERS of Washington, Ms. TORRES SMALL of New Mexico, and Mr. DAVID P. ROE of Tennessee) introduced the fol- lowing bill; which was referred to the Committee on Energy and Com- merce A BILL To reauthorize section 340H of the Public Health Service Act to continue to encourage the expansion, maintenance, and establishment of approved graduate medical resi- dency programs at qualified teaching health centers, and for other purposes. 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 ‘‘Training the Next 4 Generation of Primary Care Doctors Act of 2019’’. 5 VerDate Sep 11 2014 02:31 May 30, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2815.IH H2815 pamtmann on DSKBFK8HB2PROD with BILLS 2 •HR 2815 IH SEC. 2. FINDINGS. 1 Congress finds as follows: 2 (1) The program of payments to teaching 3 health centers for graduate medical education under 4 section 340H of the Public Health Service Act (42 5 U.S.C. 256h) was enacted in 2010 and reauthorized 6 in 2015 and 2018 to address the crisis-level shortage 7 of primary care physicians, especially in rural and 8 medically underserved communities. 9 (2) Teaching health center residents and faculty 10 will provide more than 1,000,000 primary care med- 11 ical visits in 2019 to underserved communities. 12 (3) When compared with traditional Medicare 13 GME residents, residents who train at teaching 14 health centers are more likely to practice primary 15 care and remain in underserved or rural commu- 16 nities. 17 (4) The teaching health center program not 18 only plays a vital role in training the Nation’s next 19 generation of primary care physicians (including 20 dentists), but helps bridge the Nation’s physician 21 shortfall and address the maldistribution of physi- 22 cians across the United States. 23 (5) For these reasons, it is of vital importance 24 to continue the program under section 340H of the 25 Public Health Service Act (42 U.S.C. 256h) at a 26 VerDate Sep 11 2014 02:31 May 30, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2815.IH H2815 pamtmann on DSKBFK8HB2PROD with BILLS 3 •HR 2815 IH sustainable level of funding per full-time equivalent 1 resident, as recommended in the fact sheet of the 2 Health Resources and Services Administration enti- 3 tled ‘‘Cost Estimates for Training Residents in a 4 Teaching Health Center’’. 5 SEC. 3. PAYMENTS. 6 (a) IN GENERAL.—Subsection (g) of section 340H of 7 the Public Health Service Act (42 U.S.C. 256h(g)) is 8 amended— 9 (1) by redesignating paragraph (2) as para- 10 graph (4); and 11 (2) by inserting after paragraph (1) the fol- 12 lowing: 13 ‘‘(2) PAYMENTS TO APPROVED GRADUATE MED- 14 ICAL RESIDENCY TRAINING PROGRAMS.—To carry 15 out this section, for payments to approved graduate 16 medical residency programs (as defined in paragraph 17 (j)(1) of this section), there are appropriated 18 $126,500,000 for fiscal year 2020, $128,000,000 for 19 fiscal year 2021, $130,000,000 for fiscal year 2022, 20 $133,000,000 for fiscal year 2023, and 21 $136,000,000 for fiscal year 2024, to remain avail- 22 able until expended. 23 ‘‘(3) PAYMENTS TO NEW APPROVED GRADUATE 24 MEDICAL RESIDENCY TRAINING PROGRAMS.—To 25 VerDate Sep 11 2014 02:31 May 30, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2815.IH H2815 pamtmann on DSKBFK8HB2PROD with BILLS 4 •HR 2815 IH carry out this section, for payments to new approved 1 graduate medical residency training programs (as 2 defined in paragraph (j)(2) of this section), there are 3 appropriated $8,500,000 for fiscal year 2021, 4 $17,000,000 for fiscal year 2022, $34,500,000 for 5 fiscal year 2023, and $44,000,000 for fiscal year 6 2024, to remain available until expended.’’. 7 (b) NUMBER OF RESIDENTS.—In calculating the 8 level of payments to each approved graduate medical resi- 9 dency training program pursuant to subsection (g)(2) of 10 section 340H of the Public Health Service Act (42 U.S.C. 11 256h), the Secretary of Health and Human Services shall 12 pay for the number of residents at a program at a number 13 that is no lower than the highest number of residents in 14 their programs for the period of fiscal years 2016 through 15 2018. 16 (c) LIMITATIONS.—The number of full-time equiva- 17 lent residents for which a qualified teaching health center 18 receives payments pursuant to subsection (a)(1)(C) of sec- 19 tion 340H of the Public Health Service Act (42 U.S.C. 20 256h) for a fiscal year shall not exceed by more than 6 21 the number of full-time equivalent residents for which the 22 center received such payments for the preceding fiscal 23 year. 24 VerDate Sep 11 2014 02:31 May 30, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2815.IH H2815 pamtmann on DSKBFK8HB2PROD with BILLS 5 •HR 2815 IH (d) REPORT ON EXPANSION AND TRAINING COSTS.— 1 Not later than September 30, 2022, the Secretary of 2 Health and Human Services shall submit to the Congress 3 a report on the establishment of new approved graduate 4 medical residency programs and expansion of existing ap- 5 proved graduate medical residency programs. The report 6 shall include the locations of such programs, the number 7 of residents, and statistics regarding the number of pro- 8 grams receiving priority under subsection (a)(3) of section 9 340H of the Public Health Service Act (42 U.S.C. 256h). 10 The report shall examine the direct graduate expenses of 11 approved graduate medical residency training programs; 12 the indirect expenses associated with the additional costs 13 of teaching residents; and determine the current per resi- 14 dent per year cost of training residents at qualified teach- 15 ing health centers. 16 (e) PUBLIC AVAILABILITY OF DATA.—The Secretary 17 of Health and Human Services shall make available to the 18 public the data reported by qualified teaching health cen- 19 ters pursuant to subsection (d) of this section and sub- 20 section (h)(1) of section 340H of the Public Health Serv- 21 ice Act (42 U.S.C. 256(h)). 22 Æ VerDate Sep 11 2014 02:31 May 30, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\H2815.IH H2815 pamtmann on DSKBFK8HB2PROD with BILLS