Children’s Hospital GME Support Reauthorization Act of 2023

IB Union Calendar No. 629 118TH CONGRESS 2D SESSION H. R. 3887 [Report No. 118–758] To amend title III of the Public Health Service Act to reauthorize the program of payments to children’s hospitals that operate graduate med- ical education programs, and for other purposes. IN THE HOUSE OF REPRESENTATIVES JUNE 7, 2023 Mr. CRENSHAW introduced the following bill; which was referred to the Committee on Energy and Commerce NOVEMBER 20, 2024 Additional sponsors: Mr. JOHNSON of Ohio, Mrs. MILLER-MEEKS, Mrs. HARSHBARGER, Mr. PFLUGER, Mr. BABIN, Mr. SELF, Mrs. MILLER of West Virginia, Ms. TENNEY, Mr. SANTOS, Mr. VAN DREW, Mr. GROTHMAN, Mr. SCOTT FRANKLIN of Florida, Mr. GAETZ, Mr. NEHLS, Mrs. CAMMACK, Mr. STAUBER, Mr. WILLIAMS of Texas, Mr. ARRINGTON, Mr. MANN, Mr. NORMAN, Mr. POSEY, Mr. STEUBE, Mr. ELLZEY, Mr. CARTER of Georgia, Mr. GREEN of Tennessee, Mr. JACKSON of Texas, Mr. MOONEY, Mr. DUNCAN, Mrs. MILLER of Illinois, Mr. MORAN, Mr. FINSTAD, and Mr. ROUZER NOVEMBER 20, 2024 Reported with an amendment, committed to the Committee of the Whole House on the State of the Union, and ordered to be printed [Strike out all after the enacting clause and insert the part printed in italic] [For text of introduced bill, see copy of bill as introduced on June 7, 2023] VerDate Sep 11 2014 23:51 Nov 20, 2024 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H3887.RH H3887 kjohnson on DSK7ZCZBW3PROD with $$_JOB 2 •HR 3887 RH A BILL To amend title III of the Public Health Service Act to reauthorize the program of payments to children’s hos- pitals that operate graduate medical education programs, and for other purposes. VerDate Sep 11 2014 23:51 Nov 20, 2024 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6652 E:\BILLS\H3887.RH H3887 kjohnson on DSK7ZCZBW3PROD with $$_JOB 3 •HR 3887 RH 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 ‘‘Children’s Hospital 4 GME Support Reauthorization Act of 2023’’. 5 SEC. 2. PROGRAM OF PAYMENTS TO CHILDREN’S HOS- 6 PITALS THAT OPERATE GRADUATE MEDICAL 7 EDUCATION PROGRAMS. 8 Section 340E of the Public Health Service Act (42 9 U.S.C. 256e) is amended— 10 (1) in subsection (a), by striking ‘‘2023’’ and in- 11 serting ‘‘2028’’; 12 (2) in subsection (b)(3)(D), by inserting ‘‘and 13 the end of fiscal year 2028,’’ after ‘‘fiscal year 2022,’’; 14 (3) in subsection (e), by adding at the end the 15 following new paragraph: 16 ‘‘(4) PROHIBITION ON PAYMENTS TO HOSPITALS 17 FURNISHING SPECIFIED PROCEDURES AND DRUGS TO 18 MINORS.— 19 ‘‘(A) IN GENERAL.—Notwithstanding any 20 other provision of this section, no payment may 21 be made under this section to a children’s hos- 22 pital for a fiscal year (beginning with fiscal year 23 2024) if, at any point during the preceding fis- 24 cal year, such hospital furnished specified proce- 25 VerDate Sep 11 2014 23:51 Nov 20, 2024 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6203 E:\BILLS\H3887.RH H3887 kjohnson on DSK7ZCZBW3PROD with $$_JOB 4 •HR 3887 RH dures and drugs (as defined in subsection (g)) to 1 an individual under 18 years of age. 2 ‘‘(B) SPECIAL RULE FOR FISCAL YEAR 3 2024.—In applying subparagraph (A) with re- 4 spect to payments described in such subpara- 5 graph for fiscal year 2024— 6 ‘‘(i) the reference to ‘for a fiscal year’ 7 shall be treated as a reference to ‘for any 8 portion of fiscal year 2024 occurring after 9 December 31, 2023’; and 10 ‘‘(ii) the reference to ‘the preceding fis- 11 cal year’ shall be treated as a reference to 12 ‘the period beginning on September 1, 2023, 13 and ending on December 31, 2023’. 14 ‘‘(C) RULE OF CONSTRUCTION.—Nothing in 15 this paragraph shall be construed as prohibiting 16 payments for a fiscal year (or, in the case of 17 payments for fiscal year 2024, during the por- 18 tion of such fiscal year described in subpara- 19 graph (B)(i)) to a hospital that, during the pre- 20 ceding fiscal year (or, in the case of payments 21 for fiscal year 2024, during the period described 22 in subparagraph (B)(ii)), furnished mental or 23 behavioral health services to individuals under 24 18 years of age for the treatment of gender dys- 25 VerDate Sep 11 2014 23:51 Nov 20, 2024 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6203 E:\BILLS\H3887.RH H3887 kjohnson on DSK7ZCZBW3PROD with $$_JOB 5 •HR 3887 RH phoria not consisting of specified procedures and 1 drugs.’’; 2 (4) in subsection (f)— 3 (A) in paragraph (1)(A)— 4 (i) in clause (v), by striking ‘‘and’’ at 5 the end; 6 (ii) in clause (vi), by striking the pe- 7 riod at the end and inserting ‘‘; and’’; and 8 (iii) by adding at the end the fol- 9 lowing: 10 ‘‘(vii) for each of fiscal years 2024 11 through 2028, $124,000,000.’’; and 12 (B) in paragraph (2)— 13 (i) in subparagraph (E), by striking 14 ‘‘and’’ at the end; 15 (ii) in subparagraph (F), by striking 16 the period at the end and inserting ‘‘; and’’; 17 and 18 (iii) by adding at the end the fol- 19 lowing: 20 ‘‘(G) for each of fiscal years 2024 through 21 2028, $261,000,000.’’; and 22 (5) in subsection (g), by adding at the end the 23 following new paragraph: 24 ‘‘(4) SPECIFIED PROCEDURES AND DRUGS.— 25 VerDate Sep 11 2014 23:51 Nov 20, 2024 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6203 E:\BILLS\H3887.RH H3887 kjohnson on DSK7ZCZBW3PROD with $$_JOB 6 •HR 3887 RH ‘‘(A) IN GENERAL.—Except as provided in 1 subparagraph (B), the term ‘specified procedures 2 and drugs’ means, with respect to an individual, 3 any of the following: 4 ‘‘(i) Performing any surgery for the 5 purpose of changing the body of such indi- 6 vidual to correspond to a sex that differs 7 from their biological sex, including— 8 ‘‘(I) castration; 9 ‘‘(II) orchiectomy; 10 ‘‘(III) scrotoplasty; 11 ‘‘(IV) vasectomy; 12 ‘‘(V) hysterectomy; 13 ‘‘(VI) oophorectomy; 14 ‘‘(VII) ovariectomy; 15 ‘‘(VIII) metoidioplasty; 16 ‘‘(IX) penectomy; 17 ‘‘(X) phalloplasty; 18 ‘‘(XI) vaginoplasty; 19 ‘‘(XII) vaginectomy; 20 ‘‘(XIII) vulvoplasty; 21 ‘‘(XIV) reduction 22 thyrochondroplasty; 23 ‘‘(XV) chondrolaryngoplasty; and 24 ‘‘(XVI) mastectomy. 25 VerDate Sep 11 2014 23:51 Nov 20, 2024 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6203 E:\BILLS\H3887.RH H3887 kjohnson on DSK7ZCZBW3PROD with $$_JOB 7 •HR 3887 RH ‘‘(ii) Any plastic surgery that femi- 1 nizes or masculinizes the facial features for 2 the purposes described in clause (i). 3 ‘‘(iii) Any placement of chest implants 4 to create feminine breasts for the purposes 5 described in clause (i). 6 ‘‘(iv) Any placement of fat or artificial 7 implants in the gluteal region for the pur- 8 poses described in clause (i). 9 ‘‘(v) Administering, supplying, pre- 10 scribing, dispensing, distributing, or other- 11 wise conveying to an individual medica- 12 tions for the purposes described in clause 13 (i), including— 14 ‘‘(I) gonadotropin-releasing hor- 15 mone (GnRH) analogues or other pu- 16 berty-blocking drugs to stop or delay 17 normal puberty; 18 ‘‘(II) testosterone or other 19 androgens to biological females at doses 20 that are supraphysiologic to the female 21 sex; and 22 ‘‘(III) estrogen to biological males 23 at doses that are supraphysiologic to 24 the male sex. 25 VerDate Sep 11 2014 23:51 Nov 20, 2024 Jkt 059200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6203 E:\BILLS\H3887.RH H3887 kjohnson on DSK7ZCZBW3PROD with $$_JOB 8 •HR 3887 RH ‘‘(B) EXCEPTION.—Subparagraph (A) shall 1 not apply to the following individuals: 2 ‘‘(i) An individual with both ovarian 3 and testicular tissue. 4 ‘‘(ii) An individual with respect to 5 whom a physician has determined through 6 genetic or biochemical testing that the indi- 7 vidual does not have normal sex chro- 8 mosome structure, sex steroid hormone pro- 9 duction, or sex steroid hormone action. 10 ‘‘(iii) An individual experiencing in- 11 fection, disease, injury, or disorder caused 12 or exacerbated by previous medical proce- 13 dures as defined in subsection (g)(4)(A). 14 ‘‘(iv) An individual suffering from a 15 physical disorder, physical injury, or phys- 16 ical illness that would, as certified by a 17 physician, place the individual in immi- 18 nent danger of death or impairment of a 19 major bodily function unless the procedure 20 is performed. 21 ‘‘(C) BIOLOGICAL SEX.—For purposes of 22 subparagraph (A), the term ‘biological sex’ 23 means the indication of male or female sex by re- 24 productive potential or capacity, sex chro- 25 VerDate Sep 11 2014 23:51 Nov 20, 2024 Jkt 059200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6203 E:\BILLS\H3887.RH H3887 kjohnson on DSK7ZCZBW3PROD with $$_JOB 9 •HR 3887 RH mosomes, naturally occurring sex hormones, go- 1 nads, or internal or external genitalia present at 2 birth.’’. 3 VerDate Sep 11 2014 23:51 Nov 20, 2024 Jkt 059200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6203 E:\BILLS\H3887.RH H3887 kjohnson on DSK7ZCZBW3PROD with $$_JOB Union Calendar No. 629 118TH CONGRESS 2D SESSION H. R. 3887 [Report No. 118–758] A BILL To amend title III of the Public Health Service Act to reauthorize the program of payments to chil- dren’s hospitals that operate graduate medical education programs, and for other purposes. NOVEMBER 20, 2024 Reported with an amendment, committed to the Com- mittee of the Whole House on the State of the Union, and ordered to be printed VerDate Sep 11 2014 23:51 Nov 20, 2024 Jkt 059200 PO 00000 Frm 00010 Fmt 6651 Sfmt 6651 E:\BILLS\H3887.RH H3887 kjohnson on DSK7ZCZBW3PROD with $$_JOB