Amendments

2014—Subsec. (e). Pub. L. 113–146 added subsec. (e).

Pilot Program on Graduate Medical Education and Residency

Pub. L. 115–182, title IV, §403, June 6, 2018, 132 Stat. 1472, as amended by Pub. L. 115–251, title II, §211(b)(9), Sept. 29, 2018, 132 Stat. 3177; Pub. L. 116–159, div. E, title I, §5107, Oct. 1, 2020, 134 Stat. 749, provided that:

"(a) Establishment.—

"(1) In general.—Subject to paragraph (5), the Secretary of Veterans Affairs shall establish a pilot program to establish medical residency positions authorized under section 7302 of title 38, United States Code, at covered facilities.

"(2) Covered facilities.—For purposes of this section, a covered facility is any of the following:

"(A) A health care facility of the Department of Veterans Affairs.

"(B) A health care facility operated by an Indian tribe or a tribal organization, as those terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304).

"(C) A health care facility operated by the Indian Health Service.

"(D) A Federally-qualified health center, as defined in section 1905(l)(2)(B) of the Social Security Act (42 U.S.C. 1396d(l)(2)(B)).

"(E) A health care facility operated by the Department of Defense.

"(F) Such other health care facility as the Secretary considers appropriate for purposes of this section.

"(3) Agreements.—To carry out the pilot program under this section, the Secretary may enter into agreements with entities that operate covered facilities in which the Secretary places residents under paragraph (1).

"(4) Parameters for location, affiliate sponsor, and duration.—When determining in which covered facilities to place residents under paragraph (1), the Secretary shall consider the extent to which there is a clinical need for providers in an area, as determined by the following:

"(A) The ratio of veterans to health care providers of the Department for a standardized geographic area surrounding a facility, including a separate ratio for general practitioners and specialists.

"(B) The range of clinical specialties of providers in standardized geographic areas surrounding a facility.

"(C) Whether the specialty of a provider is included in the most recent staffing shortage determination of the Department under section 7412 of title 38, United States Code.

"(D) Whether the local community is designated by the Secretary of Veterans Affairs as underserved pursuant to criteria developed under section 401 of this Act [38 U.S.C. 8110 note].

"(E) Whether the facility is located in a community that is designated by the Secretary of Health and Human Services as a health professional shortage area under section 332 of the Public Health Service Act (42 U.S.C. 254e).

"(F) Whether the facility is located in a rural or remote area.

"(G) Such other criteria as the Secretary considers important in determining which facilities are not adequately serving area veterans.

"(5) Priority in placements.—During the pilot program under this section, the Secretary shall place no fewer than 100 residents in covered facilities—

"(A) operated by the Indian Health Service;

"(B) operated by an Indian tribe;

"(C) operated by a tribal organization; or

"(D) located in communities designated by the Secretary as underserved pursuant to criteria developed under section 401 of this Act [38 U.S.C. 8110 note].

"(6) Stipends and benefits.—The Secretary may pay stipends and provide benefits for residents in positions under paragraph (1), regardless of whether they have been assigned in a Department facility.

"(b) Reimbursement.—If a covered facility establishes a new residency program in which the Secretary places a resident under the pilot program, the Secretary shall reimburse that covered facility for costs of the following:

"(1) Curriculum development.

"(2) Recruitment and retention of faculty.

"(3) Accreditation of the program by the Accreditation Council for Graduate Medical Education.

"(4) The portion of faculty salaries attributable to duties under an agreement under subsection (a)(3).

"(5) Expenses relating to educating a resident under the pilot program.

"(c) Reporting.—

"(1) In general.—Not later than 1 year after the date of the enactment of this Act [June 6, 2018] and not less frequently than once each year thereafter until the termination of the pilot program, the Secretary shall submit to Congress a report on the implementation of the pilot program.

"(2) Elements.—Each report submitted under paragraph (1) shall include the following with regard to the immediately preceding year, and in comparison to the year immediately preceding that year:

"(A) The number of veterans who received care from residents under the pilot program.

"(B) The number of veterans who received care from each resident per position described in subsection (a)(1) under the pilot program.

"(C) The number of veterans who received care from residents under the pilot program expressed as a percentage of all individuals who received care from such residents.

"(D) The number of clinical appointments for veterans conducted by each resident under the pilot program.

"(E) The number of clinical appointments for veterans conducted by residents per position described in subsection (a)(1) under the pilot program.

"(F) The number of clinical appointments for veterans expressed as a percentage of all clinical appointments conducted by residents under the pilot program.

"(G) The number of positions described in subsection (a)(1) at each covered facility under the pilot program.

"(H) For each position described in subsection (a)(1) in a residency program affiliated with a health care facility of the Department, the time a resident under the pilot program spent training at that facility of the Department, expressed as a percentage of the total training time for that resident position.

"(I) For each residency program affiliated with a health care facility of the Department, the time all residents under the pilot program spent training at that facility of the Department, expressed as a percentage of the total training time for those residents.

"(J) The time that all residents under the pilot program who are assigned to programs affiliated with health care facilities of the Department spent training at facilities of the Department, expressed as a percentage of the total training time for those residents.

"(K) The cost to the Department of Veterans Affairs under the pilot program in the year immediately preceding the report and since the beginning of the pilot program.

"(L) The cost to the Department of Veterans Affairs per resident placed under the pilot program at each covered facility.

"(M) The number of residents under the pilot program hired by the Secretary to work in the Veterans Health Administration after completion of residency in the year immediately preceding the report and since the beginning of the pilot program.

"(N) The medical specialties pursued by residents under the pilot program.

"(d) Duration.—The pilot program under this section shall terminate on August 7, 2031."

Ten-year Increase

Pub. L. 113–146, title III, §301(b)(2), Aug. 7, 2014, 128 Stat. 1785, as amended by Pub. L. 114–315, title VI, §617(a), Dec. 16, 2016, 130 Stat. 1577, provided that:

"(A) In general.—In carrying out section 7302(e) of title 38, United States Code, as added by paragraph (1), during the 10-year period beginning on the day that is 1 year after the date of the enactment of this Act [Aug. 7, 2014], the Secretary of Veterans Affairs shall increase the number of graduate medical education residency positions at medical facilities of the Department by up to 1,500 positions.

"(B) Priority.—In increasing the number of graduate medical education residency positions at medical facilities of the Department under subparagraph (A), the Secretary shall give priority to medical facilities that—

"(i) as of the date of the enactment of this Act, do not have a medical residency program; and

"(ii) are located in a community that has a high concentration of veterans."

[For definition of "facility of the Department" as used in section 301(b)(2) of Pub. L. 113–146, set out above, see section 2 of Pub. L. 113–146, set out as a note under section 1701 of this title.]