Page:United States Statutes at Large Volume 113 Part 3.djvu/154

 113 STAT. 1672 PUBLIC LAW 106-129—DEC. 6, 1999 "(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. — I f 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 pa3niients 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. "(c) AMOUNT OF PAYMENT FOR DIRECT GRADUATE MEDICAL EDU- CATION. — "(1) IN GENERAL.— The amount determined under this subsection for payments to a children's hospital for direct graduate expenses relating to approved graduate medical residency training programs for a fiscal year is equal to the product of— "(A) the updated per resident amount for direct graduate medical education, as determined under paragraph (2); and "(B) the average number of full-time equivalent residents in the hospital's graduate approved medical residency training progreuns (as determined under section 1886(h)(4) of the Socigd Security Act during the fiscal year. " (2) UPDATED PER RESIDENT AMOUNT FOR DIRECT GRADUATE MEDICAL EDUCATION.— The updated per resident Eimount for direct graduate medical education for a hospital for a fiscal ye£u* is an amount determined as follows: "(A) DETERMINATION OF HOSPITAL SINGLE PER RESIDENT AMOUNT. — The Secretary shall compute for each hospital operating an approved graduate medical education program (regardless of whether or not it is a children's hospital) . a single per resident amount equal to the average (weighted by number of full-time equivalent residents) of the primary care per resident amount and the non-primary care per resident amount computed under section 1886(h)(2) of the Social Security Act for cost reporting periods ending during fiscal year 1997. " (B) DETERMINATION OF WAGE AND NON-WAGE-RELATED PROPORTION OF THE SINGLE PER RESIDENT AMOUNT.— The Secretary shall estimate the average proportion of the single per resident amounts computed under subparagraph (A) that is attributable to wages and wage-related costs. "(C) STANDARDIZING PER RESIDENT AMOUNTS.— The Secretary shall establish a standardized per resident amount for each such hospital— "(i) by dividing the single per resident amount computed under subparagraph (A) into a wage-related portion and a non-wage-related portion by applying the proportion determined under subparagraph (B); "(ii) by dividing the wage-related portion by the factor applied under section 1886(d)(3)(E) of the Social Security Act for discharges occurring during fiscal year 1999 for the hospital's area; and

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