Amends title XVIII (Medicare) of the Social Security Act (SSA), as amended by the Balanced Budget Act of 1997, to repeal the authority and mandate for incentive payments under plans for voluntary reduction in the number of residents in a graduate medical education residency training program.

Amends the Balanced Budget Act of 1997 to prohibit the Secretary of Health and Human Services from approving or providing any payments for any demonstration project that provides for additional Medicare payments in connection with such a reduction for any residency training year beginning on or after July 1, 1998 (currently before July 1, 2006).

Provides that the April 1995 Health Care Financing Administration interpretation of Medicare secondary payer requirements for group health plans with regard to individuals with end stage renal disease (ESRD) shall not apply retroactively to a group health plan that paid benefits primary to SSA title XVIII (but would have paid benefits secondary to such title in the absence of such requirements) on or after August 10, 1993, and before April 24, 1995, on behalf of certain individuals who became entitled or eligible for the ESRD program.

Amends the Internal Revenue Code, the Employee Retirement Income Security Act of 1974, and the Public Health Service Act to extend COBRA continuation coverage for qualified ESRD Medicare beneficiaries for 36 months.

Amends SSA title XVIII to provide for an extension of the Medicare ESRD secondary payer period from 30 to 36 months.