Pub. L. 110-161, div. G, tit. II, sec. 225

Sec. 225. (a) Continuation of Availability of Permitted Number of Medical Residency Positions Under the Medicare Program.—Section 1886(h)(4)(H) of the Social Security Act (42 U.S.C. 1395ww(h)(4)(H)) is amended by adding at the end the following:“(v) Special provider agreement.—If an entity enters into a provider agreement pursuant to section 1866(a) to provide hospital services on the same physical site previously used by Medicare Provider No. 05–0578—“(I) the limitation on the number of total full time equivalent residents under subparagraph (F) and clauses (v) and (vi)(I) of subsection (d)(5)(B) applicable to such provider shall be equal to the limitation applicable under such provisions to Provider No. 05–0578 for its cost reporting period ending on June 30, 2006; and“(II) the provisions of subparagraph (G) and subsection (d)(5)(B)(vi)(II) shall not be applicable to such provider for the first three cost reporting years in which such provider trains residents under any approved medical residency training program.”.(b) Technical Correction of Section 422 of MMA.—(1) In general.—Section 1886(h)(7) of the Social Security Act (42 U.S.C. 1395ww(h)(7)) is amended—(A) by redesignating subparagraph (D) as subparagraph (E); and(B) by inserting after subparagraph (C) the following new subparagraph:“(D) Adjustment based on settled cost report.—In the case of a hospital with a dual accredited osteopathic and allopathic family practice program for which—“(i) the otherwise applicable resident limit was reduced under subparagraph (A)(i)(I); and“(ii) such reduction was based on a reference resident level that was determined using a cost report and where a revised or corrected notice of program reimbursement was issued for such cost report between September 1, 2006 and September 15, 2006, whether as a result of an appeal or otherwise, and the reference resident level under such settled cost report is higher than the level used for the reduction under subparagraph (A)(i)(I);the Secretary shall apply subparagraph (A)(i)(I) using the higher resident reference level and make any necessary adjustments to such reduction. Any such necessary adjustments shall be effective for portions of cost reporting periods occurring on or after July 1, 2005.”.(2) Effective date.—Subject to paragraph (3), the amendments made by paragraph (1) shall take effect as if included 121 STAT. 2190 in the enactment of section 422 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108–173).(c) Offsetting Costs.—(1) In general.—The amount of funds available to the Physician Assistance and Quality Initiative Fund for expenditures—(A) under the first sentence of section 1848(l)(2)(A) of the Social Security Act (42 U.S.C. 1395w–4(l)(2)(A)) is reduced by $500,000; and(B) under the first amount in the second sentence of such section is reduced by $24,500,000.(2) Conforming amendments.—Section 1848(l)(2)(A) of the Social Security Act (42 U.S.C. 1395w–4(l)(2)(A)) is amended—(A) in the first sentence, by inserting after “$1,350,000,000” the following: “, as reduced by section 524 and section 225(c)(1)(A) of the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2008 (division G of the Consolidated Appropriations Act, 2008)”; and(B) in the second sentence, by inserting after “$325,000,000” the following: “, as reduced by section 225(c)(1)(B) of such Act,”.