S.Amdt. 4980

1. Adds SEC. ___. INCREASING THE MEDICARE CAPS ON GRADUATE MEDICAL EDUCATION POSITIONS FOR STATES WITH A SHORTAGE OF RESIDENTS wherever appropriate

   Adds a section

   Inserted: SEC. ___. INCREASING THE MEDICARE CAPS ON GRADUATE MEDICAL EDUCATION POSITIONS FOR STATES WITH A SHORTAGE OF RESIDENTS.

   Inserted: (a) Direct Graduate Medical Education.--Section 1886(h)(4)(F) of the Social Security Act (42 U.S.C. 1395ww(h)(4)(F)) is amended--

   Inserted: (1) in clause (i), by inserting "clause (iii) and" after "subject to"; and

   Inserted: (2) by adding at the end the following new clause:

   Inserted: "(iii) Increase in caps on graduate medical education positions for states with a shortage of residents.--

   Inserted: "(I) In general.--For cost reporting periods beginning on or after the date that is 16 months after the date of the enactment of this clause, the Secretary shall increase the otherwise applicable limit on the total number of full-time equivalent residents in the field of allopathic or osteopathic medicine determined under clause (i) with respect to a qualifying hospital in an eligible State by an amount determined appropriate by the Secretary. Such increase shall be phased-in over a period of 5 cost reporting periods beginning with the first cost reporting period in which the increase is applied under the previous sentence to the hospital. For each eligible State the aggregate number of such increases shall be--

   Inserted: "(aa) not less than 15; and

   Inserted: "(bb) not greater than the State resident cap increase.

   Inserted: "(II) Qualifying hospital.--In this clause, the term 'qualifying hospital' means a hospital located in an eligible State that the Secretary determines should receive an increase under this clause in the otherwise applicable limit on the total number of full-time equivalent residents in the field of allopathic or osteopathic medicine.

   Inserted: "(III) Eligible state.--In this clause, the term 'eligible State' means a State for which the National median medical resident ratio exceeds the State medical resident ratio.

   Inserted: "(IV) State resident cap increase.--In this clause, the term 'State resident cap increase' means, with respect to a State, \1/4\ of the product of--

   Inserted: "(aa) the difference between the National median medical resident ratio and the State medical resident ratio; and

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   Inserted: "(bb) the State population (as determined for purposes of subclause (VI)).

   Inserted: "(V) National median medical resident ratio.--In this clause, the term 'National median medical resident ratio' means the median of all State medical resident ratios.

   Inserted: "(VI) State medical resident ratio.--In this clause, the term 'State medical resident ratio' means, with respect to any State, the ratio of full-time equivalent residents in the State in approved medical residency training programs as of the date of the enactment of this clause to the population of the State as of such date, as determined by the Secretary.

   Inserted: "(VII) State.--In this clause, the term 'State' means a State and the District of Columbia.

   Inserted: "(VIII) Considerations in determining resident cap increases.--In determining whether a hospital is a qualifying hospital, and how much of an increase in the resident cap a qualifying hospital shall receive under subclause (I), the Secretary shall take into consideration the demonstrated likelihood of the hospital filling resident positions that would be made available as a result of such increase within the first 3 cost reporting periods beginning on or after the date that is 16 months after the date of the enactment of this clause. The Secretary shall also take into consideration whether the new resident positions will be in primary care, preventive medicine, or geriatrics programs.".

   Inserted: (b) Indirect Medical Education.--Section 1886(d)(5)(B) of the Social Security Act (42 U.S.C. 1395ww(d)(5)(B)) is amended by adding at the end the following new clause:

   Inserted: "(x) Clause (iii) of subsection (h)(4)(F) shall apply to clause (v) in the same manner and for the same period as such clause (iii) applies to clause (i) of such subsection.".

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   Original wording

   At the appropriate place, insert the following:

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As printed