,i  #aae? ,,congress  #a/ ,session  ,h4 
,r4 #cdea  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,july #bg1 #bjag ,mr4 
,d5ham 7= himself & ,mr4 ,valadao7      
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce  ,a  
,,bill  ,to am5d title ,,iii ( ! ,public
 ,heal? ,s]vice ,act to exp& ! program =
 paym5ts to tea*+ heal? c5t]s ) ,,gme   
programs1 & = o!r purposes4  #a4 ,%ort  
title ,?is ,act may be cit$ z ! ,creat+ 
,additional ,resid5cy ,expansion ,act or
 ! ,,c>e ,act4  #b4 ,expansion ( program
 = paym5ts to tea*+ heal? c5t]s ) ,,gme 
programs ,section #cdj;,h ( ! ,public   
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bef;h7 is am5d$--  7#a7 9 subsection   
7g71 by ins]t+ 7o!r ?an subsection 7k77 
aft] section2  7#b7 9 subsection        
7j77#c7--  7,a7 by /rik+ c5t]4--,! &    
ins]t+ c5t]4-- 7i7 ,9 g5]al ,subject to 
clause 7ii71 !  2 &  7,b7 by add+ at !  
end ! foll[+ new clause3  7ii7 ,c>ve-out
 ( c5t]s fund$ "u subsection 7k7 ,! t]m 
qualifi$ tea*+ heal? c5t] %all n        

include1 ) respect to a fiscal ye>1 a   
c5t] t is a additional qualifi$ tea*+   
heal? c5t] 7z def9$ 9 subsection        
7k77#e77 = su* fiscal ye>4  2 &  7#c7 by
 add+ at ! end ! foll[+ new subsection3 
7k7 ,fund+ = additional qualifi$ tea*+  
heal? c5t]s  7#a7 ,paym5ts ,9 addition  
to mak+ paym5ts pursuant to subsection  
7a71 ! ,secret>y %all make paym5ts "u   
?is subsection = direct exp5ses & =     
indirect exp5ses to additional qualifi$ 
tea*+ heal? c5t]s 7z def9$ 9 p>agraph   
7#e77 t are li/$ z sponsor+ in/itutions 
by ! relevant accr$it+ body = expansion 
( exi/+ or e/abli%m5t ( additional      
approv$ graduate m$ical resid5cy tra9+  
programs4  7#b7 ,application ( program  
rules ,except z o!rwise provid$ 9 !     
succe$+ p>agraphs ( ?is subsection1     
subsections 7b71 7c71 7d71 7e71 7f71    
7h71 & 7i7 %all apply to paym5ts made   
pursuant to ?is subsection 9 ! same     
mann]1 & to ! same ext5t1 t su*         
subsections apply ) respect to paym5ts  
made pursuant to subsection 7a74  7#c7  

,limitation ,! numb] ( full-"t equival5t
 resid5ts = :i* a qualifi$ tea*+ heal?  
c5t] receives paym5ts pursuant to ?is   
subsection = a fiscal ye> %all n exce$  
by m ?an six ! numb] ( full-"t equival5t
 resid5ts = :i* ! c5t] receiv$ su*      
paym5ts = ! prec$+ fiscal ye>4  7#d7    
,appropriations ,to c>ry out ?is        
subsection1 !re are appropriat$ su* sums
 z may be necess>y1 n to exce$-- 7,a7   
#ai1jjj1jjj = fiscal ye> #bjai2 &  7,b7 
#ch1jjj1jjj = fiscal ye> #bjbj4  7#e7   
,additional qualifi$ tea*+ heal? c5t]   
def9$  7,a7 ,9 g5]al ,= purposes ( ?is  
subsection1 ! t]m additional qualifi$   
tea*+ heal? c5t] means an entity t is   
select$ by ! ,secret>y pursuant to      
subp>agraph 7,b7 & t1 b = ! application 
( subsection 7j77#c77;ii71 w\ld1 )      
respect to a fiscal ye>1 be a qualifi$  
tea*+ heal? c5t] ) respect to su* fiscal
 ye>4  7,b7 ,selection by ,secret>y  7i7
 ,9 g5]al ,= purposes ( subp>agraph     
7,a71 ! ,secret>y %all select #bj c5t]s1
 at lea/ t5 ( :i* ! ,secret>y did n make

 paym5ts to "u ?is section 9 fiscal ye> 
#bjag4  7ii7 ,priority to high-,m$icaid 
c\nties ,9 mak+ selections "u clause    
7i71 ! ,secret>y %all give priority to  
c5t]s t are locat$ 9 c\nties 9 :i*      
great] ?an #ce p]c5t ( ! population is  
enroll$ 9 ! ,m$icaid program "u title   
,,xix ( ! ,social ,security ,act4  7#f7 
,rule ( con/ruction ,no?+ 9 ?is         
subsection may be con/ru$ z limit+ !    
numb] ( qualifi$ tea*+ heal? c5t]s to   
:i* ! ,secret>y may make paym5ts = a    
fiscal ye> ) funds appropriat$ "u       
subsection 7g74  4