Sponsors (11)
The bill redirects and clarifies Medicare GME/IME payments to strengthen rural training and hospital finances—potentially improving rural clinician supply—while risking higher Medicare costs, payment shifts that create winners and losers, added costs for some rural hospitals, and short‑term administrative burdens.
Rural hospitals and rural communities receive clearer and targeted Medicare GME/IME payment treatment (including additional per‑resident payments tied to a national rural benchmark and cross‑references to the Rural Physician Workforce Production Act), improving rural hospital finances and capacity to support training.
Rural communities and the clinician workforce gain stronger incentives and funding to train residents in rural sites by paying hospitals for resident time spent in rural training locations (minimum 8 weeks) and allowing critical access/sole community hospitals special counting rules, which can increase rural clinician supply.
Hospitals get more predictable, inflation‑adjusted GME payment updates via a CPI‑U–based index, improving planning stability for GME program budgets.
Taxpayers and the Medicare program may face higher program costs or need payment offsets because the changes could increase Medicare spending or require reallocation of existing funds.
Some hospitals could see reduced DGME/IME payments because budget‑neutral adjustments offset new rural payments, creating winners and losers among hospitals.
Small rural hospitals that do not operate residency programs (or choose not to elect the program) receive no direct benefit, leaving parts of rural care networks without support.
Based on analysis of 3 sections of legislative text.
Creates an elective Medicare per‑resident payment for training in rural sites, set by a CPI‑indexed national benchmark and added into existing GME/IME rules.
Introduced February 10, 2025 by Diana Harshbarger · Last progress February 10, 2025
Creates an optional Medicare per–full-time-equivalent (FTE) resident payment for hospitals that train residents in defined rural training locations and establishes how that per‑resident payment is calculated and updated. The Secretary of HHS must set a national benchmark per‑resident amount (based on a 2015 median direct GME cost indexed by CPI‑U) with a separate urban alternative for non‑rural hospitals, and hospitals that elect the payment receive the difference between that amount and any existing direct GME funds they already get. Also revises related hospital inpatient prospective payment rules to add a cross‑reference to the new elective rural per‑resident payment and to change certain statutory text to refer to the new rural payment rules. The change is elective for hospitals and aims to support residency training in rural settings by providing an additional, CPI‑indexed per‑resident payment not reduced by Medicare patient share or DRG discharge mix.