Sponsors (19)
The bill increases Medicare reimbursements and refunds for hospital-based training costs—stabilizing hospital finances and student clinical placements and encouraging workforce programs—while raising federal Medicare spending and creating administrative and program-integrity challenges that could affect taxpayers and oversight capacity.
Hospitals and health systems can claim a broader set of nursing and allied-health education costs (including allocations from related entities) as Medicare-Allowable and will receive refunds for prior 6 years of recoupments, improving near-term hospital finances and reducing uncertainty from past audits.
Students in hospital-based nursing and allied-health programs are likely to see more stable clinical training capacity because hospitals receive fuller reimbursement for training-related costs.
Integrated health systems and related entities may be encouraged to continue or expand hospital-based education programs, supporting the health workforce pipeline at the state and system level.
Expanding allowable Medicare Part A costs to include allocations from related entities will increase Medicare spending, which could raise taxpayer costs or require offsets elsewhere in federal budgets.
Hospitals or related entities could shift or reorganize expenses to maximize Medicare reimbursement, complicating audits and increasing program-integrity risks for Medicare.
Requiring CMS to stop recoupments immediately and reprocess cost reports and refund six years of adjustments within 120 days will create significant short-term administrative and budgetary burdens for CMS and may strain state and hospital administrative capacity.
Based on analysis of 2 sections of legislative text.
Expands Medicare Part A reasonable cost rules to allow hospitals to include direct and indirect costs from related entities and training at related entities for nursing and allied health education.
Official title: To amend title XVIII of the Social Security Act to adjust allowable direct and indirect costs for nursing and allied health education programs.
Introduced February 27, 2025 by Darin Lahood · Last progress February 27, 2025
Amends Medicare hospital reasonable cost rules so hospitals can include direct and indirect costs from related entities and training that occurs at related entities when reporting costs for nursing and allied health education programs. It directs HHS to issue implementing rules within 120 days, bars Medicare Part A recoupments or payment reductions for such costs on enactment, and requires refunds for recoupments or reductions made in the prior six years. The change expands what counts as allowable Medicare reasonable costs tied to hospital-sponsored or affiliated nursing and allied health education, affecting hospital cost reporting, Medicare payments, and institutions that operate or are affiliated with clinical training programs.