This bill aims to grow the rural doctor pipeline by giving hospitals the option to get extra Medicare funding when their medical residents train in rural communities. To qualify, each resident must spend at least eight weeks training in a rural location, and the hospital must pay the resident’s salary and benefits during that time . The per‑resident payment fills the gap between a standard national training‑cost amount (based on a 2015 GAO report and updated for inflation) and what the hospital already receives, with special rules for urban hospitals and programs focused on rural training . These payments do not count against residency caps and do not change other Medicare payment rates, and overall Medicare training spending must remain budget‑neutral .

• Who is affected: General hospitals, critical access hospitals, sole community hospitals, and rural emergency hospitals; residents training in rural locations.
• What changes: Hospitals can elect to receive a per‑resident payment for rural training time; they can also be paid for all time in programs where more than half of training happens in rural areas, even if some rotations occur elsewhere.
• How payment works: It covers the difference between a standard national training‑cost amount and what the hospital already gets; urban hospitals receive the full amount for residents in rural tracks and a smaller amount if the resident is not in a rural track.
• Protections: These payments don’t reduce other training payments or count toward residency caps; the agency can adjust other training payments to keep total spending level .
• Special rules: Critical access and sole community hospitals get options for how resident time is counted so costs aren’t double‑paid.
• When: Most provisions start for hospital cost‑reporting periods that begin one year after the bill becomes law.