WASHINGTON – U.S. Senators Bill Cassidy, M.D. (R-LA), Catherine Cortez Masto (D-NV), John Cornyn (R-TX), and Michael Bennet (D-CO) introduced draft legislation to improve the Medicare Graduate Medical Education (GME) program, which makes payments to teaching hospitals for training residents and fellows in approved training programs. This bipartisan proposal aims to help increase our supply of physicians and meet the growing needs of communities across the country. This draft legislation builds on the Medicare GME Working Group’s policy proposals first outlined earlier this year to enhance GME funding.
“Doctors often practice where they do a residency. If it helps to get doctors to practice in rural and low-income areas, let’s put training programs in these areas!” said Dr. Cassidy.
“Workforce shortages are straining our health care system, especially in rural areas, and we must do more to recruit, train and retain doctors in communities across Nevada,” said Senator Cortez Masto. “That’s why I’ve been working across the aisle on this bipartisan proposal to address critical gaps in our physician workforce. I’ll continue working to ensure Nevada families in every corner of our state can access the care they need.”
“By creating new graduate medical education slots, our bill would expand access to and improve the quality of behavioral health and primary care in rural communities across the Lone Star State,” said Senator Cornyn.
“Rural Coloradans shouldn’t have to travel long distances to see a doctor,” said Senator Bennet. “This bipartisan effort will help teaching hospitals train and retain providers in rural and underserved communities. All Americans deserve access to quality health care – no matter where they live.”
Medicare supports physician training through GME payments to teaching hospitals. In 1996, Congress capped funding based on residency numbers, fearing a surplus. Nearly 30 years later, the U.S. projects a shortage of 139,940 physicians by 2036 — including 68,020 primary care doctors and 42,130 psychiatrists. By modernizing Medicare GME, this proposal aims to ensure that every state has the workforce it needs to provide the care every American deserves.
This bipartisan draft legislation would:
- Expand Medicare-supported residency positions in areas and specialties with critical shortages, like primary care and psychiatry.
- Support rural hospitals in building residency training infrastructure.
- Improve federal data collection to better allocate GME funding and address workforce gaps.
Click here to read the section-by-sectionsummary. Senators Cassidy and Cortez Masto are seeking feedback on this draft until January 31, 2024. Additional feedback would be appreciated on the following questions:
- Is the 30-slot cap appropriate for ensuring fair distribution of residency slots across hospitals? What other strategies could Congress consider to ensure hospitals in all regions have an equal opportunity to compete for slots?
- Is codifying remote supervision the best way to provide flexibility to rural hospitals, or are there alternative approaches Congress should consider?
- Are the proposed data categories in Section 7 sufficient for understanding the GME landscape without overburdening small hospitals? Are there other useful data points or reporting methods that should be included?
- Is creating a GME Policy Council the right approach to guiding future GME slot allocations? Is the scope and responsibility of the Council adequate to make it effective?
- Are there any categories of high-need hospitals with potentially higher GME costs that are not already captured in the bonus rates for the proposed standardization of PRA for new slots?
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