42 U.S.C. § 256h — Program of payments to teaching health centers that operate graduate medical education programs

maintenance of filled positions at existing approved graduate medical residency training programs;

expansion of existing approved graduate medical residency training programs; and

establishment of new approved graduate medical residency training programs.

serve a health professional shortage area with a designation in effect under section 254e of this title or a medically underserved community (as defined in section 295p of this title); or

are located in a rural area (as defined in section 1395ww(d)(2)(D) of this title).

The amount determined under subsection (c) for direct expenses associated with sponsoring approved graduate medical residency training programs.

The amount determined under subsection (d) for indirect expenses associated with the additional costs relating to teaching residents in such programs.

The total of the payments made to qualified teaching health centers under paragraph (1)(A) or paragraph (1)(B) in a fiscal year shall not exceed the amount of funds appropriated under subsection (g) for such payments for that fiscal year.

The Secretary shall limit the funding of full-time equivalent residents in order to ensure the direct and indirect payments as determined under subsection 1 (c) and (d) do not exceed the total amount of funds appropriated in a fiscal year under subsection (g).

Notwithstanding any provision of this section, for the period beginning on October 1, 2023, and ending on December 31, 2024, the Secretary may use any amounts made available in any fiscal year to carry out this section (including amounts recouped under subsection (f)) to make payments described in paragraphs (1)(A) and (1)(B), in addition to the total amount of funds appropriated under subsection (g).

the updated national per resident amount for direct graduate medical education, as determined under paragraph (2); and

the average number of full-time equivalent residents in the teaching health center’s graduate approved medical residency training programs as determined under section 1395ww(h)(4) of this title (without regard to the limitation under subparagraph (F) of such section) during the fiscal year.

The Secretary shall compute for each individual qualified teaching health center a per resident amount—

The Secretary shall update such per resident amount for each such qualified teaching health center as determined appropriate by the Secretary.

evaluate indirect training costs relative to supporting a primary care residency program in qualified teaching health centers; and

based on this evaluation, assure that the aggregate of the payments for indirect expenses under this section 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).

for the indirect costs of medical education under section 1395ww(d)(5)(B) of this title;

for direct graduate medical education costs under section 1395ww(h) of this title; and

for direct costs of medical education under section 1395ww(k) of this title;

$230,000,000, for the period of fiscal years 2011 through 2015;

$60,000,000 for each of fiscal years 2016 and 2017;

$126,500,000 for each of fiscal years 2018 through 2023;

$168,915,878 for fiscal year 2024;

$181,563,574 for fiscal year 2025;

$225,000,000 for fiscal year 2026;

$250,000,000 for fiscal year 2027;

$275,000,000 for fiscal year 2028; and

$300,000,000 for fiscal year 2029.

The types of primary care resident approved training programs that the qualified teaching health center provided for residents.

The number of approved training positions for residents described in paragraph (4).

The number of residents described in paragraph (4) who completed their residency training at the end of such residency academic year and care for vulnerable populations living in underserved areas.

The number of patients treated by residents described in paragraph (4).

The number of visits by patients treated by residents described in paragraph (4).

Of the number of residents described in paragraph (4) who completed their residency training at the end of such residency academic year, the number and percentage of such residents entering primary care practice (meaning any of the areas of practice listed in the definition of a primary care residency program in section 293l–1 of this title).

Of the number of residents described in paragraph (4) who completed their residency training at the end of such residency academic year, the number and percentage of such residents who entered practice at a health care facility—

Other information as deemed appropriate by the Secretary.

The Secretary may audit a qualified teaching health center to ensure the accuracy and completeness of the information submitted in a report under paragraph (1).

A teaching health center may only receive payment in a cost reporting period for a number of such resident positions that is greater than the base level of primary care resident positions, as determined by the Secretary. For purposes of this subparagraph, the “base level of primary care residents” for a teaching health center is the level of such residents as of a base period.

The amount payable under this section to a qualified teaching health center for a fiscal year shall be reduced by at least 25 percent if the Secretary determines that—

Before imposing a reduction under subparagraph (A) on the basis of a qualified teaching health center’s failure to provide complete and accurate information described in subparagraph (A)(ii), the Secretary shall provide notice to the teaching health center of such failure and the Secretary’s intention to impose such reduction and shall provide the teaching health center with the opportunity to provide the required information within the period of 30 days beginning on the date of such notice. If the teaching health center provides such information within such period, no reduction shall be made under subparagraph (A) on the basis of the previous failure to provide such information.

participation in which may be counted toward certification in a specialty or subspecialty and includes formal postgraduate training programs in geriatric medicine approved by the Secretary; and

that meets criteria for accreditation (as established by the Accreditation Council for Graduate Medical Education, the American Osteopathic Association, or the American Dental Association).