Children's Hospital GME Support Reauthorization Act of 2013

Mr. President, I rise on behalf of my colleagues, Senators Harkin, Alexander, Casey and Isakson to submit the following statement for the Record.

On October 30, 2013, the Health, Education, Labor, and Pensions Committee unanimously reported the Children's Hospital GME Support Reauthorization Act of 2013, S. 1557, out of Committee. On November 12, 2013, the Senate passed S. 1557 by unanimous consent.

This legislation is the product of years of bipartisan negotiation, a process which resulted in broad Senate support for the Act. The list of original Senate cosponsors for S. 1557 demonstrates this point. This list includes Senators Casey, Isakson, Harkin, Alexander, Blumenthal, Blunt, Brown, Kirk, Murphy, Reed, Roberts, Warren, and Whitehouse.

Prior to the enactment of the Children's Hospital Graduate Medical Education, CHGME, Payment Program, there was significant disparity in federal graduate medical education, GME, support between adult teaching hospitals and children's teaching hospitals. In 1998, children's hospitals received less than 0.5 percent of the level of federal GME support that adult teaching hospitals received. In the 2001 final rule for the CHGME Payment Program, the Department of Health and Human Services, HHS, wrote, ``The intent of the CHGME Act is to create parity in GME payments among all hospitals providing GME. It is clear that primarily two factors cause this disparity in children's hospitals: (1) low Medicare utilization; and (2) Prospective Payment System (PPS)- exempt status.''

The CHGME Payment Program has made considerable progress in achieving parity in GME payments, increasing the number of pediatric training positions at participating children's hospitals. However, a small number of freestanding children's teaching hospitals remain ineligible for the program. In 2003, Senate Committee on Appropriations noted the following:

It has come to the Committee's attention that a limited

number of freestanding perinatal hospitals and children's

psychiatric hospitals have been excluded from participation

in this program despite the fact that these teaching

institutions are not eligible for Graduate Medical Education

funding under Medicare. The Committee expects [the Health

Resources and Services Administration (HRSA)] to explore the

appropriateness of including these hospitals in the

Children's Hospitals Graduate Medical Education Program and

to offer recommendations that might allow for their

inclusion.

Senate Report 108-81.

HRSA responded in a 2004 report to Congress which concluded that addressing this eligibility issue would require Congress to amend the statue governing the CHGME Payment Program. S. 1557 addresses this long-standing issue. The reauthorization legislation authorizes the Secretary of the Department of Health and Human Services, HHS, to make available up to 25 percent of CHGME appropriations that exceed $245 million for ``qualified hospitals'' that: (1) have a Medicare payment agreement and are excluded from Medicare inpatient hospital prospective payment system; (2) have inpatients that are predominantly individuals under 18 years of age; (3) have an approved medical residency training program; and (4) are not otherwise eligible to receive payments from the CHGME Payment Program or the Medicare program. The total amount the Secretary can make available for these purposes in any fiscal year is limited to $7 million, thus ensuring that adequate resources remain available for the children's hospitals that currently participate in the program.

The Children's Hospital GME Support Reauthorization Act provides the Secretary with the necessary authority to address the disparity in GME payment facing certain children's teaching hospitals. These changes are in keeping with the intent of the CHGME Payment Program. As such, these hospitals should have the opportunity to apply for support through the CHGME Payment Program in order to sustain and build their teaching programs, and ultimately increase the supply of much-needed pediatricians and pediatric specialists. We urge the Secretary

to weigh these benefits in using the new authority under S. 1557 should funding be available.

Mr. Speaker, I am pleased to rise in support of S. 1557, the Children's Hospital GME Support Reauthorization Act of 2013.

As every parent knows, it's very important to have a trusted doctor to turn to when their child gets sick. Since its inception in 1999, the Children's Hospital Graduate Medical Education Program--known as CHGME--has helped to make sure that a doctor is there and prepared to diagnose any symptoms our children face.

In fact, the program has been a true success. In the 1990s declines in pediatric training programs threatened the stability of the pediatric workforce. CHGME helped to reverse these dangerous declines. Even then, Congress, on a bipartisan manner recognized that if we didn't create and fund programs that would train doctors to treat these children, there won't be anyone left to take care of them.

That is why, the House overwhelmingly supported reauthorization of the program in the 112th and 113th Congresses, passing standalone legislation in September 2011, including the reauthorization in broader legislation in December 2012, and approving standalone legislation one year ago.

The legislation before us today--which has already cleared the Senate by unanimous consent--reauthorizes the program through fiscal year 2018 and makes two important changes to the program.

First, S. 1557 allows the Secretary of Health and Human Services to undertake a limited program expansion to include children's psychiatric hospitals and other freestanding children's hospitals that have been ineligible to participate in the program for technical reasons.

Second, it gives the Secretary the authority to redistribute funding set-aside for the newly-eligible hospitals that is unused, based upon quality measures that are consistent with residency program accreditation criteria and that are developed in consultation with stakeholders.

With this federal CHGME support, children's hospitals can play a key role in ensuring the continued growth of our nation's pediatric workforce. In 2012, the program supported the training of 6,015 resident physicians nationally. The program will also help to enhance hospitals' research capabilities and improve hospitals' ability to provide care to vulnerable and underserved children.

I want to thank Congressman Joe Pitts, the Chairman of our Health Subcommittee, for working with me on the House bill. Together with his help and leadership, we advanced House CHGME legislation upon convening the 113th Congress. A special thanks to Chairman Upton and Ranking Member Waxman for their support in addressing this critical program.

I also want to commend Senators Casey and Isakson for their leadership on this legislation in the Senate and hard work to address concerns raised about children's psychiatric hospitals and other children's hospitals being excluded from the program in a fair and balanced way.

Mr. Speaker, this program has proven results and it is past time that we finally reauthorize CHGME so that we can provide certainty to hospitals, doctors and their patients.

Children in our communities are counting on this program to train a future generation of pediatricians. I urge my colleagues to vote ``yes'' on S. 1557 and to send this measure to the President.

Mr. Speaker, I yield myself such time as I may consume.

I rise today in support of the Children's Hospitals GME Support Reauthorization Act, which reauthorizes the Children's Hospital Graduate Medical Education Program through 2018.

The Children's Hospital Graduate Medical Education Program provides vital funding to support the training of pediatricians and pediatric specialists in our children's hospitals.

Continued strong support for CHGME is essential to maintain this investment in our children's health care. Reauthorizing the Children's Hospital Graduate Medical Education Program represents a commitment to ensuring that children throughout the country have access to the quality care they need.

Since its creation in 1999, this program has increased the number of pediatric health care providers, addressed critical shortages in pediatric specialty care, and improved access to necessary care.

The CHGME recipient hospitals represent less than 1 percent of all hospitals, yet train half of all the Nation's pediatricians and pediatric specialists.

As a cosponsor of the House bill that passed in 2013 and a long advocate for the Children's Hospital Graduate Medical Education Program, I applaud this bipartisan, bicameral effort to preserve and strengthen this important program.

I want to recognize and applaud the leadership of Ranking Member Frank Pallone and Chairman Pitts on this legislation in the House.

I also want to acknowledge the sponsors of the measure we are considering today, Senators Casey and Isakson. I also commend Chairman Upton, Chairman Harkin, and Ranking Member Alexander for making it possible for the House to consider this bipartisan legislation today.

I urge my colleagues to join me in supporting S. 1557 and sending this legislation to the President for his signature.

I yield back the balance of my time.

Mr. Speaker, I rise today in support of the Children's Hospitals GME Support Reauthorization Act, which reauthorizes the Children's Hospitals Graduate Medical Education (CHGME) program through 2018.

The CHGME program provides vital funding to support the training of pediatricians and pediatric specialists in children's hospitals.

Continued strong support for CHGME is essential to maintain this investment in children's health care. Reauthorizing CHGME represents a commitment to ensuring that children throughout the country have access to the quality care they need.

Since its creation in 1999, CHGME has increased the number of pediatric health care providers, addressed critical shortages in pediatric specialty care and improved access to necessary care.

The CHGME recipient hospitals represent less than one percent of all hospitals, yet train half of all the nation's pediatricians and pediatric specialists.

As a co-sponsor of the House bill that passed in February 2013 and a longtime advocate for the CHGME program, I applaud this bipartisan, bicameral effort to preserve and strengthen this important program.

Mr. Speaker, I move to suspend the rules and pass the bill (S. 1557) to amend the Public Health Service Act to reauthorize support for graduate medical education programs in children's hospitals.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and insert extraneous materials in the Record on the bill.

Mr. Speaker, I yield myself such time as I may consume.

I am glad that, today, we will pass a bill that will help keep American children healthy. Today, the House considers S. 1557, the Children's Hospital GME Support Reauthorization Act of 2013. This is companion legislation to my own bill, H.R. 297, which passed the House at the beginning of this Congress. I am pleased that we have worked out the slight differences between the bills and that we can now reauthorize an important program that makes sure our Nation has enough doctors trained to treat children.

The Children's Hospital Graduate Medical Education Program helps encourage more young doctors to pursue this important specialty. Without it, we would certainly see fewer medical professionals enter pediatrics and pediatric subspecialties.

Children need doctors trained just to treat them. Nationwide, this program supports the training of more than 5,000 doctors. Locally, in my area of Pennsylvania, the Children's Hospital of Philadelphia participates in the program.

I have had the privilege of visiting the hospital a number of times and meeting with the young patients and the doctors learning how to treat them.

I am proud to have worked on this legislation with Energy and Commerce Health Subcommittee Ranking Member Frank Pallone. We originally introduced this bill in the 112th Congress. It has been a long road. I am glad we can finally send this bill to the President for his signature.

This is yet another bipartisan bill that we have successfully moved through the Health Subcommittee. It is proof that, despite our differences, we can find common ground and work together on legislation in a bipartisan way to help Americans stay healthy.

I would like to especially thank Monica Volante on my staff, as well as the staff of the Health Subcommittee, especially Brenda Destro and Katie Novaria, who worked tirelessly on this legislation.

I urge all of my colleagues to support this bill, and I reserve the balance of my time.

Mr. Speaker, I am very pleased to ask all Members to support S. 1557, very important legislation with bipartisan support, and I yield back the balance of my time.

Mr. Speaker, I rise to support S. 1557, the Children's Hospital GME Support Reauthorization Act of 2013.

S. 1557 reauthorizes the children's hospital graduate medical education--or CHGME--program through fiscal year 2018 at an authorization level of $300 million per year. The legislation also makes two important changes to the program. It provides for a limited expansion of the CHGME program to include children's psychiatric hospitals and other children's hospitals that have been unable--to date--to participate in the program for technical reasons. It also would allow the Secretary of Health and Human Services to redistribute any remaining funding set aside for the newly-eligible hospitals that goes unused based upon quality measures.

This program provides ongoing and consistent financial support to hospitals such as Children's Hospital of Los Angeles for the training of doctors who want to specialize in pediatrics. Over the years, the CHGME program has been enormously successful in reversing the significant decline in the number of pediatrician trainees across the country. Indeed, today, children's hospitals nationwide that are supported by the program train 49% of all pediatricians and 51% of all pediatric specialists.

Not surprisingly, the CHGME program has a decade-long history of bipartisan support. The program was first established in 1999 and has subsequently been reauthorized on two occasions. During the 112th Congress and earlier this Congress, the House passed stand alone legislation that would have reauthorized the CHGME program for another five years.

I am sure that Members on both sides of the aisle agree we want to make certain this important program remains in place, and we want to send a strong message about the importance of fully funding it.

I want to recognize and applaud the leadership of Ranking Member Pallone and Chairman Pitts on CHGME legislation in the House. I also want to acknowledge the sponsors of the measure we are considering today--Senators Casey and Isakson. And, of course, I commend Chairman Upton, Chairman Harkin, and Ranking Member Alexander for making it possible for the House to consider this bipartisan legislation today.

I urge my colleagues to join me in supporting S. 1557 and sending this legislation to the President for his signature.