Page:United States Statutes at Large Volume 124.djvu/686

124 STAT. 660 PUBLIC LAW 111–148—MAR. 23, 2010 (c) APPLICATION.—The amendments made by this section shall not be applied in a manner that requires reopening of any settled hospital cost reports as to which there is not a jurisdictionally proper appeal pending as of the date of the enactment of this Act on the issue of payment for indirect costs of medical education under section 1886(d)(5)(B) of the Social Security Act (42 U.S.C. 1395ww(d)(5)(B)) or for direct graduate medical education costs under section 1886(h) of such Act (42 U.S.C. 1395ww(h)). SEC. 5505. RULES FOR COUNTING RESIDENT TIME FOR DIDACTIC AND SCHOLARLY ACTIVITIES AND OTHER ACTIVITIES. (a) GME.—Section 1886(h) of the Social Security Act (42 U.S.C. 1395ww(h)), as amended by section 5504, is amended— (1) in paragraph (4)— (A) in subparagraph (E), by striking ‘‘Such rules’’ and inserting ‘‘Subject to subparagraphs (J) and (K), such rules’’; and (B) by adding at the end the following new subpara- graphs: ‘‘(J) TREATMENT OF CERTAIN NONPROVIDER AND DIDACTIC ACTIVITIES.—Such rules shall provide that all time spent by an intern or resident in an approved medical residency training program in a nonprovider setting that is primarily engaged in furnishing patient care (as defined in paragraph (5)(K)) in non-patient care activities, such as didactic conferences and seminars, but not including research not associated with the treatment or diagnosis of a particular patient, as such time and activities are defined by the Secretary, shall be counted toward the deter- mination of full-time equivalency. ‘‘(K) TREATMENT OF CERTAIN OTHER ACTIVITIES.—In determining the hospital’s number of full-time equivalent residents for purposes of this subsection, all the time that is spent by an intern or resident in an approved medical residency training program on vacation, sick leave, or other approved leave, as such time is defined by the Secretary, and that does not prolong the total time the resident is participating in the approved program beyond the normal duration of the program shall be counted toward the deter- mination of full-time equivalency.’’; and (2) in paragraph (5), by adding at the end the following new subparagraph: ‘‘(K) NONPROVIDER SETTING THAT IS PRIMARILY ENGAGED IN FURNISHING PATIENT CARE.—The term ‘nonpro- vider setting that is primarily engaged in furnishing patient care’ means a nonprovider setting in which the primary activity is the care and treatment of patients, as defined by the Secretary.’’. (b) IME DETERMINATIONS.—Section 1886(d)(5)(B) of such Act (42 U.S.C. 1395ww(d)(5)(B)) is amended by adding at the end the following new clause: ‘‘(x)(I) The provisions of subparagraph (K) of sub- section (h)(4) shall apply under this subparagraph in the same manner as they apply under such subsection. ‘‘(II) In determining the hospital’s number of full- time equivalent residents for purposes of this subpara- graph, all the time spent by an intern or resident Applicability. Definition. 42 USC 1395ww note.