PUBLIC LAW 106-129—DEC. 6, 1999 113 STAT. 1673 "(iii) by adding the non-wage-related portion to the amount computed under clause (ii). "(D) DETERMINATION OF NATIONAL AVERAGE.—The Secretary shall compute a national average per resident amount equal to the average of the standardized per resident amounts computed under subparagraph (C) for such hospitals, with the amount for each hospital weighted by the average number of full-time equivalent residents at such hospital. "(E) APPLICATION TO INDIVIDUAL HOSPITALS. —The Secretary shall compute for each such hospital that is a children's hospital a per resident amount— "(i) by dividing the national average per resident amount computed under subparagraph (D) into a wagerelated portion and a non-wage-related portion by applying the proportion determined under subparagraph (B); "(ii) by multiplying the wage-related portion by the factor described in subparagraph (C)(ii) for the hospital's area; and "(iii) by adding the non-wage-related portion to the gimount computed under clause (ii). "(F) UPDATING RATE. —The Secretary shall update such per resident amount for each such children's hospital by the estimated percentage increase in the consumer price index for all urban consumers during the period beginning October 1997 and ending with the midpoint of the hospital's cost reporting period that begins during fiscal year 2000. " (d) AMOUNT OF PAYMENT FOR INDIRECT MEDICAL EDUCATION.— "(1) IN GENERAL.— The amount determined under this subsection for payments to a children's hospital for indirect expenses associated with the treatment of more severely ill patients and the additional costs related to the teaching of residents for a fiscal year is equal to an amount determined appropriate by the Secretary. "(2) FACTORS.— In determining the amount under paragraph (1), the Secretary shall— "(A) take into account variations in case mix among children's hospitals and the number of full-time equivalent residents in the hospitals' approved graduate medical residency training programs; and "(B) assure that the aggregate of the payments for indirect expenses associated with the treatment of more severely ill patients and the additional costs related to the teaching of residents under this section in a fiscal year are equal to the amount appropriated for such expenses for the fiscal year involved under subsection (f)(2). "(e) MAKING OF PAYMENTS.— "(1) INTERIM PAYMENTS.—The Secretary shall determine, before the beginning of each fiscal year involved for which payments may be made for a hospital under this section, the amounts of the pa3nnents for direct graduate medical education and indirect medical education for such fiscal year and shall (subject to paragraph (2)) make the payments of such amounts in 26 equal interim installments during such period.
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