Bill Summary
The "Advancing Medical Resident Training in Community Hospitals Act of 2019" is a bill that aims to amend a section of the Social Security Act, specifically relating to graduate medical education (GME) costs. This bill would establish rules for how Medicare pays for GME costs for hospitals that have established a new medical residency training program after hosting resident doctors for short periods of time. The bill would also change the rules for how Medicare determines the number of full-time-equivalent (FTE) residents a hospital can train and the limit on the number of residents that can be trained. The changes in this bill would go into effect for cost reporting periods beginning after the date of the bill's enactment.
Possible Impacts
1. This bill could potentially affect hospitals by requiring them to have a medical residency training program in place in order to receive payment for graduate medical education costs. This could lead to increased competition and potential financial strain for hospitals that do not currently have a program in place.
2. The bill may also affect medical residents by potentially limiting the number of residents that a hospital can train, as the bill states that a hospital must train at least 1.0 full-time-equivalent resident in order to receive payment for graduate medical education costs. This could potentially lead to a decrease in the number of available residency positions for medical residents.
3. The legislation could also impact Medicare beneficiaries, as the bill specifically pertains to payment under Medicare for graduate medical education costs. The changes in payment and training requirements could potentially affect the quality and availability of care for Medicare beneficiaries.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1358 Introduced in House (IH)]
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116th CONGRESS
1st Session
H. R. 1358
To amend title XVIII of the Social Security Act to establish rules for
payment for graduate medical education (GME) costs for hospitals that
establish a new medical residency training program after hosting
resident rotators for short durations.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 26, 2019
Mr. Kind (for himself, Mr. Gallagher, Mr. Sensenbrenner, Ms. Moore, Mr.
Duffy, Mr. Pocan, Mr. Grothman, and Mr. Steil) introduced the following
bill; which was referred to the Committee on Ways and Means, and in
addition to the Committee on Energy and Commerce, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to establish rules for
payment for graduate medical education (GME) costs for hospitals that
establish a new medical residency training program after hosting
resident rotators for short durations.
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 ``Advancing Medical Resident Training
in Community Hospitals Act of 2019''.
SEC. 2. MEDICARE GME TREATMENT OF HOSPITALS ESTABLISHING NEW MEDICAL
RESIDENCY TRAINING PROGRAMS AFTER HOSTING MEDICAL
RESIDENT ROTATORS FOR SHORT DURATIONS.
(a) Redetermination of Approved FTE Resident Amount.--Section
1886(h)(2)(F) of the Social Security Act (42 U.S.C. 1395ww(h)(2)(F)) is
amended--
(1) by inserting ``(i)'' before ``In the case of''; and
(2) by adding at the end the following:
``(ii) In applying this subparagraph to a hospital
that has not entered into a GME affiliation agreement
(as defined by the Secretary for purposes of paragraph
(4)(H)(ii)), the Secretary shall not provide for the
establishment of an FTE resident amount until such time
as the Secretary determines that the hospital has a
medical residency training program that trains more
than 1.0 full-time-equivalent resident in a cost
reporting period.
``(iii) In the case of a hospital with an approved
FTE resident amount--
``(I) based on the training of less than
1.0 full-time-equivalent resident before
October 1, 1997, or
``(II) based on the training of no more
than 3.0 full-time-equivalent residents in a
medical residency training program in any cost
reporting period beginning on or after October
1, 1997, and before the date of the enactment
of this clause,
the Secretary shall provide the hospital an opportunity
to have a new FTE resident amount established when the
hospital begins training at least 1.0 full-time-
equivalent resident (in the case of a hospital
described in subclause (I)) or more than 3.0 full-time-
equivalent residents (in the case of a hospital
described in subclause (II)) for cost reporting periods
beginning on or after the date of the enactment of this
clause and in accordance with the methodology under the
rules in effect as of October 1, 2015.''.
(b) Redetermination of FTE Resident Limitation.--Section
1886(h)(4)(H)(i) of the Social Security Act (42 U.S.C.
1395ww(h)(4)(H)(i)) is amended--
(1) by inserting ``(I)'' before ``The Secretary''; and
(2) by adding at the end the following:
``(II) Under this clause the Secretary
shall not determine an adjustment in the
limitation applicable to a hospital under
subparagraph (F) until the hospital trains more
than 1.0 full-time-equivalent resident in a new
medical residency training program in a cost
reporting period.
``(III) In the case of a hospital that has
a limitation under subparagraph (F) of less
than 1.0 full-time-equivalent resident as of
the date of the enactment of this subclause
based on training before October 1, 1997, under
this clause the Secretary shall provide the
hospital an opportunity to have a new
adjustment in such limitation determined when
such hospital begins training at least 1.0
full-time-equivalent resident in accordance
with the methodology applicable to hospitals
under the rules in effect as of October 1,
2015, and applied for cost reporting periods
beginning on or after the date of the enactment
of this subclause.
``(IV) In the case of a hospital for which
an adjustment in the limitation applicable to a
hospital under subparagraph (F) is based on the
training of no more than 3.0 full-time-
equivalent residents in a new medical residency
training program in a cost reporting period
beginning on or after October 1, 1997, and
before the date of the enactment of this
subclause, the Secretary shall provide the
hospital an opportunity to have a new
adjustment in such limitation determined when
the hospital begins training more than 3.0
full-time-equivalent residents in accordance
with the methodology applicable to hospitals
under the rules in effect as of October 1,
2015, and applied for cost reporting periods
beginning on or after the date of the enactment
of this subclause.''.
(c) Effective Date.--The amendments made by this section shall
apply to payment under section 1886 of the Social Security Act (42
U.S.C. 1395ww) for cost reporting periods beginning on or after the
date of the enactment of this Act.
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