Page:United States Statutes at Large Volume 111 Part 1.djvu/502

 Ill STAT. 478 PUBLIC LAW 105-33 —AUG. 5, 1997 "(G) COUNTING INTERNS AND RESIDENTS FOR FY 1998 AND SUBSEQUENT YEARS. — "(i) IN GENERAL.— For cost reporting periods beginning during fiscal years beginning on or after October 1, 1997, subject to the limit described in subparagraph (F), the total number of full-time equivalent residents for determining a hospital's graduate medical education payment shall equal the average of the actual full-time equivalent resident counts for the cost reporting period and the preceding two cost reporting periods. "(ii) ADJUSTMENT FOR SHORT PERIODS.—If any cost reporting period beginning on or after October 1, 1997, is not equal to twelve months, the Secretary shall make appropriate modifications to ensure that the average full-time equivalent resident counts pursuant to clause (i) are based on the equivalent of full twelvemonth cost reporting periods. "(iii) TRANSITION RULE FOR 1998.— In the case of a hospital's first cost reporting period beginning on or after October 1, 1997, clause (i) shall be applied by using the average for such period and the preceding cost reporting period. "(H) SPECIAL RULES FOR APPLICATION OF SUBPARA- GRAPHS (F) AND (G). — "(i) NEW FACILITIES. — The Secretary shall, consistent with the principles of subparagraphs (F) and (G), prescribe rules for the application of such subparagraphs in the case of medical residency training programs established on or after January 1, 1995. In promulgating such rules for purposes of subparagraph (F), the Secretary shall give special consideration to facilities that meet the needs of underserved rural areas. "(ii) AGGREGATION. — The Secretary may prescribe rules which allow institutions which are members of the same affiliated group (as defined by the Secretary) to elect to apply the limitation of subparagraph (F) on an aggregate basis. "(iii) DATA COLLECTION.—The Secretary may require any entity that operates a medical residency training program and to which subparagraphs (F) and (G) apply to submit to the Secretary such additional information as the Secretary considers necessary to carry out such subparagraphs.". SEC. 4624. PAYMENTS TO HOSPITALS FOR DIRECT COSTS OF GRAD- UATE MEDICAL EDUCATION OF MEDICARE+CHOICE ENROLLEES. Section 1886(h)(3) (42 U.S.C. 1395ww(h)(3)) is amended by adding after subparagraph (C) the following: "(D) PAYMENT FOR MANAGED CARE ENROLLEES.— "(i) IN GENERAL.— For portions of cost reporting periods occurring on or after January 1, 1998, the Secretary shall provide for an additional payment amount under this subsection for services furnished to individuals who are enrolled under a risk-sharing contract with an eligible organization under section

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