; and (2) by adding at the end the following: (ii) In applying this subparagraph to a hospital that has not entered into a GME affiliation agreement (as defined by the Secretary for purposes of paragraph (4)(H)(ii)), the Secretary shall not provide for the establishment of an FTE resident amount until such time as the Secretary determines that the hospital has a medical residency training program that trains more than 1.0 full-time-equivalent resident in a cost reporting period. (iii) In the case of a hospital with an approved FTE resident amount— (I) based on the training of less than 1.0 full-time-equivalent resident before October 1, 1997, or (II) based on the training of no more than— (aa) for any cost reporting period beginning on or after October 1, 1996, and before October 1, 1997, 6.0 full-time-equivalent residents in a medical residency training program, or (bb) for any cost reporting period beginning on or after October 1, 1997, 3.0 full-time-equivalent residents in a medical residency training program, or (III) based on the training of no full-time-equivalent residents in a medical residency training program for any ten consecutive cost reporting periods beginning on or after October 1, 1997, the Secretary shall provide the hospital an opportunity to have a new FTE resident amount established when the hospital begins training at least 1.0 full-time-equivalent resident (in the case of a hospital described in subclauses (I or III)) or more than 3.0 full-time-equivalent residents (in the case of a hospital described in subclause (II)) for cost reporting periods beginning on or after the date of the enactment of this clause and in accordance with the methodology under the rules in effect as of October 1, 2015. . (b) Redetermination of FTE resident limitation Section 1886(h)(4)(H)(i) of the Social Security Act ( 42 U.S.C. 1395ww(h)(4)(H)(i) ) is amended— (1) by inserting (I) before The Secretary