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42 U.S. Code § 256e. Program of payments to children’s hospitals that operate graduate medical education programs
(a) Payments
The Secretary shall make two payments under this section to each children’s hospital for each of fiscal years 2000 through 2005, each of fiscal years 2007 through 2011, each of fiscal years 2014 through 2018, and each of fiscal years 2019 through 2023, one for the direct expenses and the other for indirect expenses associated with operating approved graduate medical residency training programs. The Secretary shall promulgate regulations pursuant to the rulemaking requirements of title 5 which shall govern payments made under this subpart.
(b) Amount of payments
(1) In generalSubject to paragraphs (2) and (3), the amounts payable under this section to a children’s hospital for an approved graduate medical residency training program for a fiscal year are each of the following amounts:
(A) Direct expense amount
The amount determined under subsection (c) for direct expenses associated with operating approved graduate medical residency training programs.
(B) Indirect expense amount
The amount determined under subsection (d) for indirect expenses associated with the treatment of more severely ill patients and the additional costs relating to teaching residents in such programs.
(2) Capped amount
(A) In general
The total of the payments made to children’s hospitals under paragraph (1)(A) or paragraph (1)(B) in a fiscal year shall not exceed the funds appropriated under paragraph (1) or (2), respectively, of subsection (f) for such payments for that fiscal year.
(B) Pro rata reductions of payments for direct expenses
If the Secretary determines that the amount of funds appropriated under subsection (f)(1) for a fiscal year is insufficient to provide the total amount of payments otherwise due for such periods under paragraph (1)(A), the Secretary shall reduce the amounts so payable on a pro rata basis to reflect such shortfall.
(3) Annual reporting required
(A) Reduction in payment for failure to report
(i) In generalThe amount payable under this section to a children’s hospital for a fiscal year (beginning with fiscal year 2008 and after taking into account paragraph (2)) shall be reduced by 25 percent if the Secretary determines that—
(I)
the hospital has failed to provide the Secretary, as an addendum to the hospital’s application under this section for such fiscal year, the report required under subparagraph (B) for the previous fiscal year; or
(II)
such report fails to provide the information required under any clause of such subparagraph.
(ii) Notice and opportunity to provide missing information
Before imposing a reduction under clause (i) on the basis of a hospital’s failure to provide information described in clause (i)(II), the Secretary shall provide notice to the hospital of such failure and the Secretary’s intention to impose such reduction and shall provide the hospital with the opportunity to provide the required information within a period of 30 days beginning on the date of such notice. If the hospital provides such information within such period, no reduction shall be made under clause (i) on the basis of the previous failure to provide such information.
(B) Annual reportThe report required under this subparagraph for a children’s hospital for a fiscal year is a report that includes (in a form and manner specified by the Secretary) the following information for the residency academic year completed immediately prior to such fiscal year:
(i)
The types of resident training programs that the hospital provided for residents described in subparagraph (C), such as general pediatrics, internal medicine/pediatrics, and pediatric subspecialties, including both medical subspecialties certified by the American Board of Pediatrics (such as pediatric gastroenterology) and non-medical subspecialties approved by other medical certification boards (such as pediatric surgery).
(ii)
The number of training positions for residents described in subparagraph (C), the number of such positions recruited to fill, and the number of such positions filled.
(iii)
The types of training that the hospital provided for residents described in subparagraph (C) related to the health care needs of different populations, such as children who are underserved for reasons of family income or geographic location, including rural and urban areas.
(iv) The changes in residency training for residents described in subparagraph (C) which the hospital has made during such residency academic year (except that the first report submitted by the hospital under this subparagraph shall be for such changes since the first year in which the hospital received payment under this section), including—
(I)
changes in curricula, training experiences, and types of training programs, and benefits that have resulted from such changes; and
(II)
changes for purposes of training the residents in the measurement and improvement of the quality and safety of patient care.
(v)
The numbers of residents described in subparagraph (C) who completed their residency training at the end of such residency academic year and care for children within the borders of the service area of the hospital or within the borders of the State in which the hospital is located. Such numbers shall be disaggregated with respect to residents who completed residencies in general pediatrics or internal medicine/pediatrics, subspecialty residencies, and dental residencies.
(C) ResidentsThe residents described in this subparagraph are those who—
(i)
are in full-time equivalent resident training positions in any training program sponsored by the hospital; or
(ii)
are in a training program sponsored by an entity other than the hospital, but who spend more than 75 percent of their training time at the hospital.
(D) Report to CongressNot later than the end of fiscal year 2018, and the end of fiscal year 2022, the Secretary, acting through the Administrator of the Health Resources and Services Administration, shall submit a report to the Congress—
(i)
summarizing the information submitted in reports to the Secretary under subparagraph (B);
(ii)
describing the results of the program carried out under this section; and
(iii)
making recommendations for improvements to the program.