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1 plicable resident limit under this para-
2 graph for other hospitals in the State
3 in accordance with this clause.
4 ‘‘(II) PROCESS FOR HOSPITALS

5 IN CERTAIN AREAS.—In determining

6 for which hospitals the increase in the
7 otherwise applicable resident limit de-
8 scribed in subclause (I) is provided,
9 the Secretary shall establish a process
10 to provide for such increase to one or
11 more hospitals located in the State.
12 Such process shall take into consider-
13 ation the recommendations submitted
14 to the Secretary by the senior health
15 official (as designated by the chief ex-
16 ecutive officer of such State) if such
17 recommendations are submitted not
18 later than 180 days after the date of
19 the hospital closure involved (or, in
20 the case of a hospital that closed after
21 the date that is 2 years before the
22 date of the enactment of this clause,
23 180 days after such date of enact-
24 ment).

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1 ‘‘(III) LIMITATION.—The esti-
2 mated aggregate number of increases
3 in the otherwise applicable resident
4 limits for hospitals under this clause
5 shall be equal to the estimated num-
6 ber of resident positions in the ap-
7 proved medical residency programs
8 that closed on or after the date de-
9 scribed in subclause (I).’’.
10 (b) NO EFFECT ON TEMPORARY FTE CAP ADJUST-
11 MENTS.—The amendments made by this section shall not
12 effect any temporary adjustment to a hospital’s FTE cap
13 under section 413.79(h) of title 42, Code of Federal Regu-
14 lations (as in effect on the date of enactment of this Act)
15 and shall not affect the application of section
16 1886(h)(4)(H)(v) of the Social Security Act.
17 (c) CONFORMING AMENDMENTS.—
18 (1) Section 422(b)(2) of the Medicare Prescrip-
19 tion Drug, Improvement, and Modernization Act of
20 2003 (Public Law 108–173), as amended by section
21 1501(c), is amended by striking ‘‘(7) and’’ and in-
22 serting ‘‘(4)(H)(vi), (7), and’’.
23 (2) Section 1886(h)(7)(E) of the Social Secu-
24 rity Act (42 U.S.C. 1395ww(h)(7)(E)) is amended

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1 by inserting ‘‘or under paragraph (4)(H)(vi)’’ after
2 ‘‘under this paragraph’’.
3 SEC. 1505. IMPROVING ACCOUNTABILITY FOR APPROVED

4 MEDICAL RESIDENCY TRAINING.

5 (a) SPECIFICATION OF GOALS FOR APPROVED MED-

6 ICAL RESIDENCY TRAINING PROGRAMS.—Section
7 1886(h)(1) of the Social Security Act (42 U.S.C.
8 1395ww(h)(1)) is amended—
9 (1) by designating the matter beginning with
10 ‘‘Notwithstanding’’ as a subparagraph (A) with the
11 heading ‘‘IN GENERAL.—’’ and with appropriate in-
12 dentation; and
13 (2) by adding at the end the following new
14 paragraph:
15 ‘‘(B) GOALS AND ACCOUNTABILITY FOR

16 APPROVED MEDICAL RESIDENCY TRAINING PRO-

17 GRAMS.—The goals of medical residency train-

18 ing programs are to foster a physician work-
19 force so that physicians are trained to be able
20 to do the following:
21 ‘‘(i) Work effectively in various health
22 care delivery settings, such as nonprovider
23 settings.

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1 ‘‘(ii) Coordinate patient care within
2 and across settings relevant to their spe-
3 cialties.
4 ‘‘(iii) Understand the relevant cost
5 and value of various diagnostic and treat-
6 ment options.
7 ‘‘(iv) Work in inter-professional teams
8 and multi-disciplinary team-based models
9 in provider and nonprovider settings to en-
10 hance safety and improve quality of patient
11 care.
12 ‘‘(v) Be knowledgeable in methods of
13 identifying systematic errors in health care
14 delivery and in implementing systematic
15 solutions in case of such errors, including
16 experience and participation in continuous
17 quality improvement projects to improve
18 health outcomes of the population the phy-
19 sicians serve.
20 ‘‘(vi) Be meaningful EHR users (as
21 determined under section 1848(o)(2)) in
22 the delivery of care and in improving the
23 quality of the health of the community and
24 the individuals that the hospital serves.’’

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1 (b) GAO STUDY ON EVALUATION OF TRAINING PRO-
2 GRAMS.—

3 (1) IN GENERAL.—The Comptroller General of

4 the United States shall conduct a study to evaluate
5 the extent to which medical residency training pro-
6 grams—
7 (A) are meeting the goals described in sec-
8 tion 1886(h)(1)(B) of the Social Security Act,
9 as added by subsection (a), in a range of resi-
10 dency programs, including primary care and
11 other specialties; and
12 (B) have the appropriate faculty expertise
13 to teach the topics required to achieve such
14 goals.
15 (2) REPORT.—Not later than 18 months after
16 the date of the enactment of this Act, the Comp-
17 troller General shall submit to Congress a report on
18 such study and shall include in such report rec-
19 ommendations as to how medical residency training
20 programs could be further encouraged to meet such
21 goals through means such as—
22 (A) development of curriculum require-
23 ments; and
24 (B) assessment of the accreditation proc-
25 esses of the Accreditation Council for Graduate

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1 Medical Education and the American Osteo-
2 pathic Association and effectiveness of those
3 processes in accrediting medical residency pro-
4 grams that meet the goals referred to in para-
5 graph (1)(A).
6 TITLE VI—PROGRAM INTEGRITY
7 Subtitle A—Increased Funding to
8 Fight Waste, Fraud, and Abuse
9 SEC. 1601. INCREASED FUNDING AND FLEXIBILITY TO

10 FIGHT FRAUD AND ABUSE.

11 (a) IN GENERAL.—Section 1817(k) of the Social Se-

12 curity Act (42 U.S.C. 1395i(k)) is amended—
13 (1) by adding at the end the following new
14 paragraph:
15 ‘‘(7) ADDITIONAL FUNDING.—In addition to the
16 funds otherwise appropriated to the Account from
17 the Trust Fund under paragraphs (3) and (4) and
18 for purposes described in paragraphs (3)(C) and
19 (4)(A), there are hereby appropriated an additional
20 $100,000,000 to such Account from such Trust
21 Fund for each fiscal year beginning with 2011. The
22 funds appropriated under this paragraph shall be al-
23 located in the same proportion as the total funding
24 appropriated with respect to paragraphs (3)(A) and
25 (4)(A) was allocated with respect to fiscal year

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687
1 2010, and shall be available without further appro-
2 priation until expended.’’.
3 (2) in paragraph (4)(A)—
4 (A) by inserting ‘‘for activities described in
5 paragraph (3)(C) and’’ after ‘‘necessary’’; and
6 (B) by inserting ‘‘until expended’’ after
7 ‘‘appropriation’’.
8 (b) FLEXIBILITY IN PURSUING FRAUD AND

9 ABUSE.—Section 1893(a) of the Social Security Act (42

10 U.S.C. 1395ddd(a)) is amended by inserting ‘‘, or other-
11 wise,’’ after ‘‘entities’’.
12 Subtitle B—Enhanced Penalties for
13 Fraud and Abuse
14 SEC. 1611. ENHANCED PENALTIES FOR FALSE STATEMENTS

15 ON PROVIDER OR SUPPLIER ENROLLMENT

16 APPLICATIONS.

17 (a) IN GENERAL.—Section 1128A(a) of the Social

18 Security Act (42 U.S.C. 1320a–7a(a)) is amended—
19 (1) in paragraph (1)(D), by striking all that fol-
20 lows ‘‘in which the person was excluded’’ and insert-
21 ing ‘‘under Federal law from the Federal health care
22 program under which the claim was made, or’’;
23 (2) by striking ‘‘or’’ at the end of paragraph
24 (6);

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688
1 (3) in paragraph (7), by inserting at the end
2 ‘‘or’’;
3 (4) by inserting after paragraph (7) the fol-
4 lowing new paragraph:
5 ‘‘(8) knowingly makes or causes to be made any
6 false statement, omission, or misrepresentation of a
7 material fact in any application, agreement, bid, or
8 contract to participate or enroll as a provider of
9 services or supplier under a Federal health care pro-
10 gram, including managed care organizations under
11 title XIX, Medicare Advantage organizations under
12 part C of title XVIII, prescription drug plan spon-
13 sors under part D of title XVIII, and entities that
14 apply to participate as providers of services or sup-
15 pliers in such managed care organizations and such
16 plans;’’;
17 (5) in the matter following paragraph (8), as
18 inserted by paragraph (4), by striking ‘‘or in cases
19 under paragraph (7), $ 50,000 for each such act)’’
20 and inserting ‘‘in cases under paragraph (7),
21 $50,000 for each such act, or in cases under para-
22 graph (8), $50,000 for each false statement, omis-
23 sion, or misrepresentation of a material fact)’’; and
24 (6) in the second sentence, by striking ‘‘for a
25 lawful purpose)’’ and inserting ‘‘for a lawful pur-

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