Summary

Creates an optional Medicare per‑resident payment for hospitals when residents spend time training in defined rural locations. The payment is based on the 2015 median national direct GME training cost (updated by CPI‑U) minus any existing DME payments the hospital already receives, is elective for eligible hospitals, and must be implemented in a budget‑neutral way within Medicare’s GME/IME payment rules. Specifies eligibility rules (minimum rural training time or >50% rural tracks for full payment), counting rules for FTE residents, special treatment options for critical access hospitals, technical statutory edits to existing GME/IME language, and an effective date tied to hospital cost reporting periods beginning one year after enactment.

Key Points

• Establishes an optional Medicare per‑resident payment for residents who train in approved rural locations.
• Payment amount is based on the 2015 median national direct GME cost updated by CPI‑U and reduced by any DME the hospital already receives.
• Hospitals, CAHs, SCHs, and rural emergency hospitals may elect the payment for cost reporting periods starting one year after enactment.
• Residents must spend at least 8 weeks in a rural training location (or >50% rural training in a program/track for full payment) to count.
• Aggregate IME and DME payments (including the new payment) must remain budget‑neutral; CMS may adjust other payments to achieve neutrality.
• CAHs may elect special counting treatment (hospital vs. non‑provider setting) with limits on claiming DME when another hospital receives payment.
• Sole community hospitals’ hospital‑specific payment calculations exclude direct GME costs to the extent the SCH receives the elective payment.
• Includes technical statutory edits and cross‑references to integrate the elective payment into existing IME/DME formulas.

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