Page:United States Statutes at Large Volume 113 Part 2.djvu/892

 113 STAT. 1501A-374 PUBLIC LAW 106-113—APPENDIX F (B) IME. —The amendment made by paragraph (2) appHes to discharges occurring in cost reporting periods that begin on or after such date of enactment. (b) PERMITTING 30 PERCENT EXPANSION IN CURRENT GME TRAINING PROGRAMS FOR HOSPITALS LOCATED IN RURAL AREAS. — (1) PAYMENT FOR DIRECT GRADUATE MEDICAL EDUCATION.— Section 1886(h)(4)(F)(i) (42 U.S.C. 1395ww(h)(4)(F)(i)), as amended by subsection (a)(1), is amended by inserting "(or, 130 percent of such number in the case of a hospital located in a rural area)" after "may not exceed the number". (2) PAYMENT FOR INDIRECT MEDICAL EDUCATION.—Section 1886(d)(5)(B)(v) (42 U.S.C. 1395ww(d)(5)(B)(v)) is amended by inserting "(or, 130 percent of such number in the case of a hospital located in a rural area)" after "may not exceed the number". (3) EFFECTIVE DATES.— (A) DOME. —The amendment made by paragraph (1) applies to cost reporting periods beginning on or after April 1, 2000. (B) IME.— The amendment made by paragraph (2) applies to discharges occurring on or after April 1, 2000. (c) SPECIAL RULE FOR NONRURAL FACILITIES SERVING RURAL AREAS ' (1) IN GENERAL.—Section 1886(h)(4)(H) (42 U.S.C. 1395ww(h)(4)(H)) is amended by adding at the end the following new clause: " (iv) NONRURAL HOSPITALS OPERATING TRAINING PROGRAMS IN RURAL AREAS.— In the case of a hospital that is not located in a rural area but establishes separately accredited approved medical residency training programs (or rural tracks) in an rural area or has an accredited training program with an integrated rural track, the Secretary shall adjust the limitation under subparagraph (F) in an appropriate manner insofar as it applies to such programs in such rural areas in order to encourage the training of physicians in rural areas.". (2) EFFECTIVE DATE. —The amendment made by paragraph (1) applies with respect to— (A) payments to hospitals under section 1886(h) of the Social Security Act (42 U.S.C. 1395ww(h)) for cost reporting periods beginning on or after April 1, 2000; and (B) payments to hospitals under section 1886(d)(5)(B)(v) of such Act (42 U.S.C. 1395ww(d)(5)(B)(v)) for discharges occurring on or after April 1, 2000. (d) NOT COUNTING AGAINST NUMERICAL LIMITATION CERTAIN INTERNS AND RESIDENTS TRANSFERRED FROM A VA RESIDENCY PRO- GRAM THAT LOSES ACCREDITATION. — (1) IN GENERAL. —Any applicable resident described in paragraph (2) shall not be taken into account in applying any limitation regarding the number of residents or interns for which payment may be made under section 1886 of the Social Security Act (42 U.S.C. 1395ww). (2) APPLICABLE RESIDENT DESCRIBED. —An applicable resident described in this paragraph is a resident or intern who— (A) participated in graduate medical education at a facility of the Department of Veterans Affairs;

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