Children's Hospitals Educational Equity and Research Act or the CHEER Act - Amends the Public Health Service Act to require the Secretary of Health and Human Services to make payments through FY 2010 (currently, through FY 2005) to children's hospitals for expenses associated with operating approved graduate medical residency training programs.
Excludes reductions for unused resident positions when calculating the number of full-time residents in a children's hospital's approved training program for purposes of reimbursing direct expenses.
Requires the Secretary to: (1) adjust the proportion of such a hospital's costs attributable to wages for differences in hospital wage levels by geographic area; and (2) consider the ratio of residents in such a hospital's approved training program to beds (but excluding beds or bassinets assigned to healthy new born infants) when determining the amount of payments to such a hospital for indirect expenses associated with the treatment of more severely ill patients and for the additional costs associated with teaching residents in such programs.
Authorizes appropriations through FY 2010 for direct and indirect expenses associated with operating such programs.
Expresses the sense of the Senate that: (1) perinatal hospitals play an important role in providing quality care and ensuring the best possible outcomes for thousands of seriously ill newborns each year; and (2) medical training programs at perinatal hospitals give providers essential training in treating healthy mothers and babies as well as patients in neonatal intensive care units.
[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 2526 Introduced in Senate (IS)]
108th CONGRESS
2d Session
S. 2526
To reauthorize the Children's Hospitals Graduate Medical Education
Program.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 16, 2004
Mr. Bond (for himself, Mr. Kennedy, Mr. DeWine, and Mrs. Murray)
introduced the following bill; which was read twice and referred to the
Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To reauthorize the Children's Hospitals Graduate Medical Education
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 ``Children's Hospitals Educational
Equity and Research Act'' or the ``CHEER Act''.
SEC. 2. REAUTHORIZATION OF CHILDREN'S HOSPITALS GRADUATE MEDICAL
EDUCATION PROGRAM.
(a) Extension of Program.--Section 340E(a) of the Public Health
Service Act (42 U.S.C. 256e(a)) is amended by striking ``2005'' and
inserting ``2010''.
(b) Description of Amount of Payments.--Section 340E(b) of the
Public Health Service Act (42 U.S.C. 256e(b)) is amended--
(1) in paragraph (1)(B), by striking ``relating to teaching
residents in such'' and inserting ``associated with graduate
medical residency training''; and
(2) in paragraph (2)(A), by inserting before the period at
the end ``, except as provided under paragraphs (1)(A) and
(2)(B) of subsection (f)''.
(c) Direct Graduate Medical Education.--Section 340E(c) of the
Public Health Service Act (42 U.S.C. 245e(c)) is amended--
(1) in paragraph (1)--
(A) in the matter preceding subparagraph (A), by
striking ``product'' and inserting ``sum'';
(B) in subparagraph (A), by striking ``(A) the
updated per resident'' and inserting the following:
``(A) the product of--
``(i) the updated per resident''.
(C) by redesignating subparagraph (B) as clause
(ii) and indenting appropriately;
(D) in subparagraph (A)(ii) (as so redesignated)--
(i) by inserting ``but without giving
effect to section 1886(h)(7) of such Act''
after ``section 1886(h)(4) of the Social
Security Act''; and
(ii) by striking the period and inserting
``; and''; and
(E) by inserting after subparagraph (A) the
following:
``(B) amounts for other approved education programs
that are provider-operated, as defined for purposes of
Medicare payment, limited to not more than 30 percent
of costs that would be allowed for such programs under
Medicare rules for hospitals reimbursed under section
1886(d) of the Social Security Act.''; and
(2) in paragraph (2)(B), by inserting before the period at
the end ``, without giving effect to section 1886(d)(3)(E)(ii)
of the Social Security Act''.
(d) Indirect Graduate Medical Education.--Section 340E(d) of the
Public Health Service Act (42 U.S.C. 256e(d)) is amended--
(1) in paragraph (1), by striking ``related to'' and
inserting ``associated with''; and
(2) in paragraph (2)(A)--
(A) by inserting ``ratio of the'' after ``hospitals
and the''; and
(B) by inserting at the end before the semicolon
``to beds (but excluding beds or bassinets assigned to
healthy newborn infants)''.
(e) Nature of Payments.--Section 340E(e) of the Public Health
Service Act (42 U.S.C. 256e(e)) is amended--
(1) in paragraph (2), by striking the first sentence;
(2) in paragraph (3)--
(A) by striking ``made to pay'' and inserting
``made and pay''; and
(B) by striking ``to the extent possible'' and all
that follows through the end of the paragraph and
inserting the following: ``. To the greatest extent
possible, amounts recouped from a hospital are to be
distributed to other hospitals in the same fiscal year.
Amounts recouped from a hospital and not disbursed to
other hospitals in the same fiscal year shall remain
available for distribution during the subsequent fiscal
year. Unless there is fraud, amounts paid to a hospital
without a demand for recoupment by the end of the
fiscal year shall be final and not subject to
recoupment.''; and
(3) by adding at the end the following:
``(4) Appeals.--
``(A) In general.--A decision affecting the amount
payable to a hospital pursuant to this section shall--
``(i) be subject to review under section
1878 of the Social Security Act in the same
manner as a final determination of a fiscal
intermediary of the amount of payment under
1886(d) of such Act is subject to review; and
``(ii) be handled expeditiously so that the
review decision is reflected in the final
reconciliation for the year in which the appeal
is made.
``(B) Limitation.--A review decision pursuant to
this section shall not affect payments for a fiscal
year prior to the fiscal year in which the review decision is rendered.
``(C) Application to subsequent fiscal years.--The
Secretary shall apply a review decision in determining
the amount of payment for the appealing hospital in the
fiscal year in which the decision is rendered and in
subsequent years, unless the law at issue in the review
decision is amended or there are material differences
between the facts for the fiscal year for which the
review decision is rendered and the year for which
payment is made. Nothing in this section shall be
construed to prohibit a hospital from appealing similar
determinations in subsequent periods.''.
(f) Authorization of Appropriations.--Section 340E(f) of the Public
Health Service Act (42 U.S.C. 256e(f)) is amended--
(1) in paragraph (1)--
(A) in subparagraph (A)--
(i) in clause (ii), by striking ``and'';
(ii) in clause (iii), by striking the
period at the end and inserting a semicolon;
and
(iii) by adding at the end the following:
``(iv) for fiscal year 2006, $110,000,000;
and
``(v) for each of fiscal years 2007 through
2010, such sums as may be necessary, including
an annual adjustment to reflect increases in
the Consumer Price Index.''; and
(B) in subparagraph (B), by striking ``for fiscal
year 2000'' and all that follows and inserting ``for
fiscal year 2006 and each subsequent fiscal year shall
remain available for obligation for the year
appropriated and the subsequent fiscal year.''; and
(2) in paragraph (2)--
(A) by redesignating subparagraphs (A), (B), and
(C) as clauses (i), (ii), and (iii), respectively, and
indenting appropriately;
(B) by striking ``There are hereby authorized'' and
inserting the following:
``(A) In general.--There are authorized'';
(C) in clause (ii) (as redesignated by this
paragraph), by striking ``and'';
(D) in clause (iii) (as redesignated by this
paragraph), by striking the period at the end and
inserting a semicolon;
(E) by adding at the end of subparagraph (A) (as
designated by this paragraph), the following:
``(iv) for fiscal year 2006, $220,000,000;
and
``(v) for each of fiscal years 2007 through
2010, such sums as may be necessary, including
an annual adjustment to reflect increases in
the Consumer Price Index.''; and
(F) at the end of paragraph (2), by adding the
following:
``(B) Carryover of excess.--To the extent that
amounts are not expended in the year for which they are
appropriated, the amounts appropriated under
subparagraph (A) for fiscal year 2006 and each
subsequent fiscal year shall remain available for
obligation through the end of the following fiscal
year.''.
(g) Definitions.--Section 340E(g)(3) of the Public Health Service
Act (42 U.S.C. 256e(g)(3)) is amended by striking ``has'' and all that
follows through the end of the sentence and inserting the following:
``includes--
``(A) the meaning given such term in section
1886(h)(5)(C) of the Social Security Act; and
``(B) costs of approved educational activities, as
such term is used in section 1886(a)(4) of the Social
Security Act.''.
<all>
Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Committee on Health, Education, Labor, and Pensions. Ordered to be reported with an amendment in the nature of a substitute favorably.
Committee on Health, Education, Labor, and Pensions. Reported by Senator Gregg with an amendment in the nature of a substitute. With written report No. 108-388.
Committee on Health, Education, Labor, and Pensions. Reported by Senator Gregg with an amendment in the nature of a substitute. With written report No. 108-388.
Placed on Senate Legislative Calendar under General Orders. Calendar No. 774.
Passed/agreed to in Senate: Passed Senate with an amendment by Unanimous Consent.(consideration: CR S11385-11386; text as passed Senate: CR S11385-11386; text of measure as reported in Senate: CR S11385)
Passed Senate with an amendment by Unanimous Consent. (consideration: CR S11385-11386; text as passed Senate: CR S11385-11386; text of measure as reported in Senate: CR S11385)
Message on Senate action sent to the House.
Received in the House.
Llama 3.2 · runs locally in your browser
Ask anything about this bill. The AI reads the full text to answer.
Enter to send · Shift+Enter for new line
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.