Page:United States Statutes at Large Volume 124.djvu/688

124 STAT. 662 PUBLIC LAW 111–148—MAR. 23, 2010 increase in the otherwise applicable resident limit is provided under such process, the Secretary shall distribute the increase to hospitals in the following priority order (with preference given within each category to hospitals that are members of the same affiliated group (as defined by the Secretary under clause (ii)) as the closed hospital): ‘‘(aa) First, to hospitals located in the same core-based statistical area as, or a core- based statistical area contiguous to, the hos- pital that closed. ‘‘(bb) Second, to hospitals located in the same State as the hospital that closed. ‘‘(cc) Third, to hospitals located in the same region of the country as the hospital that closed. ‘‘(dd) Fourth, only if the Secretary is not able to distribute the increase to hospitals described in item (cc), to qualifying hospitals in accordance with the provisions of paragraph (8). ‘‘(III) REQUIREMENT HOSPITAL LIKELY TO FILL POSITION WITHIN CERTAIN TIME PERIOD.—The Sec- retary may only increase the otherwise applicable resident limit of a hospital under such process if the Secretary determines the hospital has dem- onstrated a likelihood of filling the positions made available under this clause within 3 years. ‘‘(IV) LIMITATION.—The aggregate number of increases in the otherwise applicable resident limits for hospitals under this clause shall be equal to the number of resident positions in the approved medical residency programs that closed on or after the date described in subclause (I). ‘‘(V) ADMINISTRATION.—Chapter 35 of title 44, United States Code, shall not apply to the implementation of this clause.’’. (b) IME.—Section 1886(d)(5)(B)(v) of the Social Security Act (42 U.S.C. 1395ww(d)(5)(B)(v)), in the second sentence, as amended by section 5503, is amended by striking ‘‘subsections (h)(7) and (h)(8)’’ and inserting ‘‘subsections (h)(4)(H)(vi), (h)(7), and (h)(8)’’. (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. Section 1395ww(h)). (d) EFFECT ON TEMPORARY FTE CAP ADJUSTMENTS.—The Sec- retary of Health and Human Services shall give consideration to the effect of the amendments made by this section on any temporary adjustment to a hospital’s FTE cap under section 413.79(h) of title 42, Code of Federal Regulations (as in effect on the date of enactment of this Act) in order to ensure that there is no duplication of FTE slots. Such amendments shall not affect the 42 USC 1395ww note. 42 USC 1395ww note. Determination.