; (2) in subparagraph (J), by striking Such rules and inserting Subject to subparagraph (M), such rules ; (3) in subparagraph (K), by striking In determining and inserting Subject to subparagraph (M), in determining ; and (4) by adding at the end the following new subparagraph: (M) Treatment of certain residents and interns For purposes of cost-reporting periods beginning on or after October 1, 2019, in determining the hospital’s number of full-time equivalent residents for purposes of this paragraph, all the time spent by an intern or resident in an approved medical residency training program shall be counted toward the determination of full-time equivalency if the hospital— (i) is recognized as a subsection (d) hospital; (ii) is recognized as a subsection (d) Puerto Rico hospital; (iii) is reimbursed under a reimbursement system authorized under section 1814(b)(3); or (iv) is a provider-based hospital outpatient department. . (b) IME determinations Section 1886(d)(5)(B)(xi) of the Social Security Act ( 42 U.S.C. 1395ww(d)(5)(B)(xi) ), as redesignated by section 204(b), is amended— (1) in subclause (II), by striking In determining and inserting Subject to subclause (IV), in determining ; (2) in subclause (III), by striking In determining and inserting Subject to subclause (IV), in determining ; and (3) by inserting after subclause (III) the following new subclause: (IV) For purposes of cost-reporting periods beginning on or after October 1, 2019, the provisions of subparagraph (M) of subsection (h)(4) shall apply under this subparagraph in the same manner as they apply under such subsection. . 309. Developing and implementing strategies for local health equity (a) Grants The Secretary of Health and Human Services, acting jointly with the Secretary of Education and the Secretary of Labor, shall make grants to institutions of higher education for the purposes of— (1) in accordance with subsection (b), developing capacity— (A) to build an evidence base for successful strategies for increasing local health equity