S 541 IS

To amend title XVIII of the Social Security Act to make certain changes related to payments for graduate medical education under the Medicare Program.

March 4, 1999

Ms. COLLINS (for herself, Mr. MURKOWSKI, and Mr. ROBERTS) introduced the following bill; which was read twice and referred to the Committee on Finance

To amend title XVIII of the Social Security Act to make certain changes related to payments for graduate medical education under the Medicare Program.

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 `Graduate Medical Education Technical Amendments of 1999'.

SEC. 2. INDIRECT GRADUATE MEDICAL EDUCATION ADJUSTMENT.

(a) IN GENERAL- Section 1886(d)(5)(B)(v) of the Social Security Act (42 U.S.C. 1395ww(d)(5)(B)(v)) (as added by section 4621(b) of the Balanced Budget Act of 1997) is amended--

(1) by striking `(v) In determining' and inserting `(v)(I) Subject to subclause (II), in determining';

(2) by striking `in the hospital with respect to the hospital's most recent cost reporting period ending on or before December 31, 1996'; and inserting `who were appointed by the hospital's approved medical residency training programs for the hospital's most recent cost reporting period ending on or before December 31, 1996'; and

(3) by adding at the end the following:

`(II) Beginning on or after January 1, 1997, in the case of a hospital that sponsors only 1 allopathic or osteopathic residency program, the limit determined for such hospital under subclause (I) may, at the hospital's discretion, be increased by 1 for each calendar year but shall not exceed a total of 3 more than the limit determined for the hospital under subclause (I).'.

(b) TECHNICAL AMENDMENTS- Section 1886(d)(5)(B) of the Social Security Act (42 U.S.C. 1395ww(d)(5)(B)) is amended by moving clauses (ii), (v), and (vi) 2 ems to the left.

SEC. 3. DIRECT GRADUATE MEDICAL EDUCATION ADJUSTMENT.

(a) LIMITATION ON NUMBER OF RESIDENTS- Section 1886(h)(4)(F) of the Social Security Act (42 U.S.C. 1395ww(h)(4)(F)) (as added by section 4623 of the Balanced Budget Act of 1997) is amended by inserting `who were appointed by the hospital's approved medical residency training programs' after `may not exceed the number of such full-time equivalent residents'.

(b) FUNDING FOR NEW PROGRAMS- The first sentence of section 1886(h)(4)(H)(i) of the Social Security Act (42 U.S.C. 1395ww(h)(4)(H)(i)) (as added by section 4623 of the Balanced Budget Act of 1997) is amended by inserting `and before September 30, 1999' after `January 1, 1995'.

(c) FUNDING FOR PROGRAMS MEETING RURAL NEEDS- The second sentence of section 1886(h)(4)(H)(i) of the Social Security Act (42 U.S.C. 1395ww(h)(4)(H)(i)) (as added by section 4623 of the Balanced Budget Act of 1997) is amended by striking the period at the end and inserting `, including facilities that are not located in an underserved rural area but have established separately accredited rural training tracks.'.

SEC. 4. EFFECTIVE DATE.

The amendments made by this Act shall take effect as if included in the enactment of the Balanced Budget Act of 1997.

END