HR2314-119

What This Bill Does

The FAIR Act uses Medicare graduate medical education payment pressure to require transparency about osteopathic and allopathic residency applicants. For discharges on or after October 1, 2026, a hospital's relevant Medicare payment amount is reduced by 2 percent for each prior fiscal year, beginning with fiscal year 2025, for which the hospital has not submitted required information to HHS. Required information includes the number of applicants to each approved residency program from osteopathic medical schools and allopathic medical schools, the number accepted from each type, and an affirmation that the hospital considers both osteopathic and allopathic applicants and accepts either COMLEX-USA or USMLE scores when an exam score is required, at the applicant's election. HHS must publish the applicant counts, acceptance counts, and affirmations on a public website. The bill states that it does not federalize medical education or mandate acceptance of any number of osteopathic or allopathic students.

Who Benefits and How

Osteopathic medical students benefit from public reporting and affirmations that residency programs consider DO applicants and accept COMLEX scores. Allopathic medical students benefit from transparent applicant and acceptance data by school type. Residency applicants benefit from public data on how hospitals treat osteopathic and allopathic candidates. Medical education researchers benefit from HHS-published program-level applicant and acceptance data.

Who Bears the Burden and How

Teaching hospitals must submit annual applicant counts, acceptance counts, and policy affirmations or face a 2 percent Medicare payment reduction per missing year. Hospital residency program administrators must track osteopathic and allopathic applicant data by program and fiscal year. HHS Medicare payment staff must apply reductions and publish residency information on a public website. Residency programs that prefer only one licensing exam must accept COMLEX-USA or USMLE at the applicant's election if an exam score is required.

Key Provisions

• Requires teaching hospitals to report osteopathic and allopathic residency applicant and acceptance counts.
• Requires hospitals to affirm that they consider both applicant types and accept COMLEX-USA or USMLE scores at the applicant's election.
• Reduces the relevant Medicare payment amount by 2 percent for each prior fiscal year of nonreporting beginning with fiscal year 2025.
• Directs HHS to publish the reported counts and affirmations on a public website.
• States that the bill does not federalize medical education or mandate acceptance of any number of students.