[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1087 Introduced in Senate (IS)]

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119th CONGRESS
  1st Session
                                S. 1087

  To amend title XVIII of the Social Security Act to adjust allowable 
   direct and indirect costs for nursing and allied health education 
                               programs.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 14, 2025

  Ms. Klobuchar (for herself and Mr. Tillis) introduced the following 
  bill; which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
  To amend title XVIII of the Social Security Act to adjust allowable 
   direct and indirect costs for nursing and allied health education 
                               programs.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Rebuild America's Health Care 
Schools Act of 2025''.

SEC. 2. ADJUSTING ALLOWABLE DIRECT AND INDIRECT COSTS FOR NURSING AND 
              ALLIED HEALTH EDUCATION PROGRAMS.

    (a) In General.--Section 1861(v)(1) of the Social Security Act (42 
U.S.C. 1395x(v)(1)) is amended by adding at the end the following new 
subparagraph:
    ``(X)(i) In determining such reasonable costs for nursing and 
allied health education furnished by a hospital, beginning with respect 
to cost reporting periods beginning on or after the date of the 
enactment of the Rebuild America's Health Care Schools Act of 2025, the 
Secretary shall include as reasonable costs all direct and indirect 
costs incurred by a hospital participating in a nursing and allied 
health education program licensed by State law or accredited by a 
national or regional professional organization, including costs that--
            ``(I) were directly incurred by the hospital;
            ``(II) were allocated to the hospital by a related entity 
        holding the applicable State license or accreditation by a 
        national or regional professional organization;
            ``(III) were associated with the training or advanced 
        clinical training of a program participant at the hospital or 
        at a related entity;
            ``(IV) were associated with contracts to provide for 
        faculty for the program when such faculty are employed by an 
        educational institution that is not a related entity; or
            ``(V) were associated with shared services, such as shared 
        payroll and administrative services, to support the operation 
        of an approved nursing or allied health education program, 
        provided by an educational institution or a clinical site that 
        is a related entity.
    ``(ii) For purposes of clause (i), the term `related entity' means, 
with respect to a hospital, any entity that is related by common 
ownership or control to--
            ``(I) the hospital itself; or
            ``(II) an entity--
                    ``(aa) in which the hospital (or another entity 
                that is a related entity with respect to the hospital) 
                is the sole corporate member;
                    ``(bb) that is the sole corporate member of the 
                hospital;
                    ``(cc) that is part of the same legal entity as the 
                hospital; or
                    ``(dd) that shares a board with the hospital.''.
    (b) Allowing Health Systems and Hospital-Based Schools To Provide 
Clinical Training and Support.--Not later than 120 days after the date 
of the enactment of this section, the Secretary of Health and Human 
Services shall issue such rules as are necessary to carry out the 
amendments made by subsection (a).
    (c) Prohibiting Recoupment of Certain Costs Under Medicare.--
            (1) In general.--Beginning on the date of the enactment of 
        this section, the Secretary of Health and Human Services may 
        not recoup or reduce payments made to a hospital under part A 
        of title XVIII of the Social Security Act (42 U.S.C. 1395c et 
        seq.) for costs related to an approved nursing or allied health 
        education program that are included on the Medicare cost report 
        for such hospital if such costs would be allowable after the 
        amendments made by subsection (a) take effect.
            (2) Refund of amounts recouped.--If, during the 6-year 
        period ending on the date of the enactment of this section, the 
        Secretary recouped or reduced payments made to a hospital under 
        such part A for costs described in paragraph (1), the Secretary 
        shall refund to the hospital the amount so recouped or reduced.
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