Page:United States Statutes at Large Volume 124.djvu/698

124 STAT. 672 PUBLIC LAW 111–148—MAR. 23, 2010 and the payments for direct graduate medical education as determined under subsection (c) in a fiscal year do not exceed the amount appropriated for such expenses as determined in subsection (g). ‘‘(3) INTERIM PAYMENT.—Before the Secretary makes a pay- ment under this subsection pursuant to a determination of indirect expenses under paragraph (1), the Secretary may pro- vide to qualified teaching health centers a payment, in addition to any payment made under subsection (c), for expected indirect expenses associated with the additional costs of teaching resi- dents for a fiscal year, based on an estimate by the Secretary. ‘‘(e) CLARIFICATION REGARDING RELATIONSHIP TO OTHER PAY- MENTS FOR GRADUATE MEDICAL EDUCATION.—Payments under this section— ‘‘(1) shall be in addition to any payments— ‘‘(A) for the indirect costs of medical education under section 1886(d)(5)(B) of the Social Security Act; ‘‘(B) for direct graduate medical education costs under section 1886(h) of such Act; and ‘‘(C) for direct costs of medical education under section 1886(k) of such Act; ‘‘(2) shall not be taken into account in applying the limita- tion on the number of total full-time equivalent residents under subparagraphs (F) and (G) of section 1886(h)(4) of such Act and clauses (v), (vi)(I), and (vi)(II) of section 1886(d)(5)(B) of such Act for the portion of time that a resident rotates to a hospital; and ‘‘(3) shall not include the time in which a resident is counted toward full-time equivalency by a hospital under para- graph (2) or under section 1886(d)(5)(B)(iv) of the Social Secu- rity Act, section 1886(h)(4)(E) of such Act, or section 340E of this Act. ‘‘(f) RECONCILIATION.—The Secretary shall determine any changes to the number of residents reported by a hospital in the application of the hospital for the current fiscal year to determine the final amount payable to the hospital for the current fiscal year for both direct expense and indirect expense amounts. Based on such determination, the Secretary shall recoup any overpayments made to pay any balance due to the extent possible. The final amount so determined shall be considered a final intermediary determination for the purposes of section 1878 of the Social Security Act and shall be subject to administrative and judicial review under that section in the same manner as the amount of payment under section 1186(d) of such Act is subject to review under such section. ‘‘(g) FUNDING.—To carry out this section, there are appropriated such sums as may be necessary, not to exceed $230,000,000, for the period of fiscal years 2011 through 2015. ‘‘(h) ANNUAL REPORTING REQUIRED.— ‘‘(1) ANNUAL REPORT.—The report required under this para- graph for a qualified teaching health center for a fiscal year is a report that includes (in a form and manner specified by the Secretary) the following information for the residency academic year completed immediately prior to such fiscal year: ‘‘(A) The types of primary care resident approved training programs that the qualified teaching health center provided for residents. Determination.