FAIR Act
- Bill Number
- H.R. 2314
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-03-25: Referred to the House Committee on Ways and Means.
- Last Updated
- 2026-06-09T08:05:48Z
AI-Generated Summary
Purpose of the Legislation
The Fair Access In Residency Act of 2025 (FAIR Act of 2025) aims to promote transparency and fairness in the residency application process for graduates of osteopathic medical schools (which train doctors of osteopathic medicine, or DOs) and allopathic medical schools (which train doctors of medicine, or MDs). It requires hospitals receiving federal Medicare funding for training programs to report data on applicant numbers, acceptances, and policies, without mandating admissions quotas.
Key Provisions
- Reporting Requirements: Starting in fiscal year 2025, hospitals with Medicare-approved medical residency training programs must submit annual data to the Secretary of Health and Human Services (HHS), including:
- The number of applicants to each program from osteopathic and allopathic schools.
- The number of applicants accepted from each type of school.
- An affirmation that the hospital's policy considers applicants from both types of schools and, if exam scores are required, accepts either the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) or the United States Medical Licensing Examination (USMLE) at the applicant's choice.
- Financial Penalty for Non-Compliance: For hospital discharges on or after October 1, 2026, Medicare's indirect medical education (IME) payment adjustment—a funding boost for hospitals training residents—will be reduced by 2% for each prior fiscal year (starting 2025) in which the required information was not submitted.
- Public Transparency: HHS must publish the submitted data and affirmations on a public website for each fiscal year, covering information on applicants, acceptances, and policies.
- Limitations: The law explicitly states it does not federalize medical education or require programs to accept any specific number of students from osteopathic or allopathic schools.
Significant Changes to Existing Law
- Amends Section 1886(d)(5)(B) of the Social Security Act, which governs Medicare payments to hospitals for indirect medical education costs.
- Introduces new subclause (xiv) mandating the reporting of applicant and acceptance data by school type, along with policy affirmations.
- Adds a penalty mechanism to the IME payment formula, linking federal funding to compliance with transparency rules—previously, no such reporting or penalty existed for distinguishing between osteopathic and allopathic candidates.
Potential Impacts
- On Government Agencies: HHS gains administrative responsibilities for collecting, verifying, and publishing data, potentially increasing workload but enhancing oversight of Medicare-funded training programs.
- On Citizens: Medical school graduates (especially DOs, who may face barriers in matching to residencies) benefit from greater transparency, helping them make informed application choices. Hospitals may adjust policies to avoid penalties, indirectly promoting fairer access without quotas.
- On International Relations: No direct impacts, as the bill focuses on domestic U.S. medical training and Medicare funding.
Main Stakeholders Affected
- Hospitals with Residency Programs: Primary targets, as they must comply with reporting to maintain full Medicare IME payments; non-compliance could reduce funding.
- Osteopathic and Allopathic Medical Students/Graduates: Gain visibility into program acceptance rates and policies, potentially reducing biases in the residency matching process.
- HHS and Medicare Program: Responsible for enforcement, data publication, and payment adjustments.
- Medical Accrediting Bodies (e.g., Accreditation Council for Graduate Medical Education): Indirectly influenced, as the bill promotes policy affirmations without altering accreditation standards.
Notable Legal, Constitutional, or Political Implications
- Legal: Ties compliance to federal Medicare funding, a common mechanism for influencing behavior without direct mandates; the "rule of construction" clause protects against challenges by clarifying no quotas or federal takeover of education.
- Constitutional: Minimal concerns, as it conditions voluntary participation in Medicare on reporting, respecting states' roles in medical education under the 10th Amendment; avoids compelled speech issues by framing affirmations as policy statements.
- Political: Bipartisan sponsorship (from both parties) signals broad support for addressing perceived inequities in residency access, potentially setting a precedent for data-driven reforms in healthcare workforce development without controversial mandates.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Rep. Harshbarger, Diana [R-TN-1]
Cosponsors (18)
Rep. Pingree, Chellie [D-ME-1], Rep. Graves, Sam [R-MO-6], Rep. Miller, Carol D. [R-WV-1], Rep. Davis, Donald G. [D-NC-1], Rep. Kelly, Mike [R-PA-16], Rep. Thompson, Glenn [R-PA-15], Rep. Rogers, Mike D. [R-AL-3], Rep. Cohen, Steve [D-TN-9], Rep. Bacon, Don [R-NE-2], Rep. Burchett, Tim [R-TN-2], Rep. Cline, Ben [R-VA-6], Rep. Vasquez, Gabe [D-NM-2], Rep. McGuire, John J. [R-VA-5], Rep. Owens, Burgess [R-UT-4], Rep. Crawford, Eric A. "Rick" [R-AR-1], Rep. Goldman, Craig A. [R-TX-12], Rep. Bean, Aaron [R-FL-4], Rep. Kiggans, Jennifer A. [R-VA-2]
Recent Actions
- 2025-03-25: Referred to the House Committee on Ways and Means.
- 2025-03-25: Introduced in House
- 2025-03-25: Introduced in House
Bill Versions
- Fair Access In Residency Act — issued 2025-03-25 — PDF (4 pages)