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Congress Passes Cap Flexibility Report Language in FY 2020 Final Appropriations Bill

We are extremely happy to report that the FY 2020 Appropriations bills include Cap-Flexibility language in two different locations. The appropriation bills passed the House of Representatives on Tuesday, December 17, 2019 and the Senate on Thursday, December 19, 2019. More information below.


Short memorandum summary of Cap-Flexibility language in FFY 2020 Appropriations bill can be found here.

We cannot thank Congressman Henry Cuellar, Ph.D. (TX-28-D) for his leading the charge and ensuring the inclusion of the Cap Flexibility inspired language in the appropriations bill. Were it not for his efforts, we would not have succeeded! Additionally, special thanks go to Senator Cindy Hyde-Smith (MS-R), Senator John Cornyn (TX-R), and Senator Lamar Alexander (TN-R) who worked to ensure the House language stayed in the Senate draft of the appropriations bill.


Upon passage of the appropriations bill with the Cap Flexibility language included, Congressman Cuellar stated:


Many under-served rural communities in the United States, like the Rio Grande Valley, suffer from a poor distribution of physicians and training programs, making it difficult for patients to see a doctor and receive medical care.”


“For this reason, I worked hard to secure language in the final spending bill that allows medical schools and teaching hospitals in areas of greatest need, such as Doctors Hospital at Renaissance, have additional residency positions. I am committed to ensuring people in the Rio Grande Valley and across the country have access to quality health care. I want to thank the Cap Flexibility Coalition for their dedication to training the next generation of physicians and commitment to ensuring that no community in the United States has to suffer from an inadequate supply of physicians.”


And of course special thanks goes to Dr. Raul Ruiz (CA-36-D) and Dr. John Barrasso (WY-R) who are spearheading legislative efforts to get cap flexibility legislation introduced next year.


Language in FY 2020 Appropriations Bill – Pg. 102


· Graduate Medical Education Program.-In conjunction with new medical residency programs language included in House Report 116-62, the agreement encourages CMS to extend the time described in section 413.79(e) of title 42, Code of Federal Regulations, for new residency programs before a full-time equivalent resident cap is applied as authorized in P.L. 105-33.


House Report 116-62: Pg. 137:


· New Medical Residency Training Programs.—Given the growing physician workforce shortage, the Committee strongly encourages CMS to utilize its discretion to extend the time period described in section 413.79(e) of title 42, Code of Federal Regulations, for new residency programs in areas facing physician shortages before a full-time equivalent resident cap is applied, as authorized in P.L. 105–33. Moreover, the Committee recommends that the agency meet with physician, hospital, and other industry stakeholders from underserved areas to better understand changes in population health. The agency shall provide an update to the Committees on Appropriations on these efforts within 90 days of enactment of this Act.


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