79R5721 CLG-D


By:  Chavez, Solis                                                H.B. No. 2420



A BILL TO BE ENTITLED

AN ACT

relating to the allocation of federal funds directed to be used to 
support graduate medical education in connection with the state 
Medicaid program.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Section 32.0315, Human Resources Code, is 
amended by amending Subsection (b) and adding Subsections (a-1) and 
(a-2) to read as follows:
	(a-1)  For purposes of allocating funds to a teaching 
hospital under this section, the department shall establish a 
separate formula for funds used to support the training of resident 
physicians in an accredited residency program for a primary care 
field of allopathic or osteopathic medicine that:
		(1)  is sponsored by or affiliated with a public 
university in this state; and
		(2)  includes clinical training of resident physicians 
in:           
			(A)  a federally qualified health center, as 
defined by 42 U.S.C. Section 1395x(aa)(4); and
			(B)  a hospital that:                                                 
				(i)  is located within 20 miles of the 
international border with Mexico; and
				(ii)  serves patients residing in a rural 
area, as defined by 42 U.S.C. Section 1395ww(d)(2)(D).
	(a-2)  In establishing the formula required by Subsection 
(a-1), the department:
		(1)  may not place a limit on the number of physician 
residency training slots; and
		(2)  must recognize direct and indirect medical 
expenditures of the residency program eligible for reimbursement 
under the medical assistance program to the same extent those 
direct and indirect medical expenditures are recognized under the 
Medicare program.
	(b)  The department shall allocate the funds in the manner 
the department determines most effectively and equitably achieves 
the purposes for which those federal funds are received, consistent 
with the needs of this state for graduate medical education and the 
training of resident physicians in accredited residency programs in 
appropriate fields and specialties, taking into account other money 
available to support graduate medical education.  In determining 
the needs of this state for graduate medical education, the 
department shall give primary emphasis to graduate medical 
education in primary care specialties and shall also give emphasis 
to graduate medical education in a residency program described by 
Subsection (a-1).
	SECTION 2.  If before implementing any provision of this Act 
a state agency determines that a waiver or authorization from a 
federal agency is necessary for implementation of that provision, 
the agency affected by the provision shall request the waiver or 
authorization and may delay implementing that provision until the 
waiver or authorization is granted.
	SECTION 3.  This Act takes effect September 1, 2005.