FAIR Act of 2025
- Bill Number
- S. 2715
- Origin Chamber
- Senate
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-09-04: Read twice and referred to the Committee on Finance.
- Last Updated
- 2025-12-18T12:03:20Z
AI-Generated Summary
Purpose
The Fair Access In Residency Act of 2025 (FAIR Act of 2025) aims to promote transparency and equitable consideration of candidates from osteopathic medical schools (which focus on a holistic approach including musculoskeletal manipulation) and allopathic medical schools (which follow a more traditional biomedical model) in hospital residency training programs. It requires hospitals to report data on applicants and acceptances to help address potential biases in the residency selection process without mandating specific admissions.
Key Provisions
- Reporting Requirements: Hospitals with approved medical residency training programs must submit annual information to the Secretary of Health and Human Services (HHS) starting in fiscal year 2025. This includes:
- The number of applicants to each program from osteopathic and allopathic medical 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 scores from either the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) or the United States Medical Licensing Examination (USMLE), at the applicant's choice.
- Financial Penalty for Non-Compliance: For hospital discharges occurring on or after October 1, 2026, Medicare payments under the indirect medical education (IME) adjustment—a formula that provides extra funding to teaching hospitals for resident training—will be reduced by 2% for each prior fiscal year (starting with 2025) in which the hospital fails to submit the required information.
- Public Disclosure: HHS must publish the submitted applicant numbers, acceptance data, and affirmations on a public website for each fiscal year, covering programs defined under the Social Security Act.
- Limitations: The law explicitly states it does not federalize medical education (i.e., it does not place medical training under direct federal control) 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's IME payments to hospitals.
- Introduces new subclause (xiv) mandating the specific reporting on osteopathic and allopathic candidates, which was not previously required.
- Adds a penalty mechanism tied to IME payments, creating financial incentives for compliance that did not exist before.
- Requires public publication of residency data, enhancing transparency beyond current reporting obligations.
Potential Impacts
- On Government Agencies: HHS gains administrative responsibilities for collecting, verifying, and publicly posting data, potentially increasing workload and costs. The Medicare program may see reduced payments to non-compliant hospitals, affecting federal healthcare spending.
- On Citizens: Medical students and graduates from osteopathic and allopathic schools benefit from greater visibility into residency opportunities, which could help identify and reduce disparities in access. This may encourage more balanced recruitment practices over time.
- On Hospitals: Teaching hospitals face new compliance burdens and risk payment cuts (up to 2% per non-compliant year), which could strain budgets but promote fairer application processes.
- On International Relations: No direct impacts, as the legislation focuses on domestic U.S. medical education and Medicare funding.
Main Stakeholders Affected
- Hospitals with Residency Programs: Primary reporters and subjects of penalties; must update policies and tracking systems.
- Osteopathic and Allopathic Medical Students/Graduates: Gain transparency to better navigate residency applications and advocate for equal treatment.
- Medical Schools: Indirectly affected through data on their graduates' application success rates, potentially influencing recruitment and curriculum adjustments.
- HHS and Medicare Administrators: Responsible for enforcement, data publication, and payment adjustments.
- Professional Organizations: Groups like the American Osteopathic Association and American Medical Association may use the data to monitor equity in residency matching.
Notable Legal, Constitutional, or Political Implications
- Legal: Strengthens federal oversight of Medicare-funded residency programs by tying funding to transparency, but the "rule of construction" clause protects against challenges by clarifying no quotas or federal control over admissions, preserving hospitals' autonomy under the Social Security Act.
- Constitutional: Aligns with Congress's spending power to condition federal funds (Medicare payments) on reporting, without infringing on states' rights to regulate medical education; unlikely to raise First Amendment issues as it mandates factual reporting, not speech suppression.
- Political: Bipartisan sponsorship (by Senators Daines, Heinrich, and King) signals broad support for addressing perceived inequities in medical training pipelines, potentially influencing future healthcare workforce policies without imposing mandates that could spark opposition from hospital lobbies.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (7)
Sen. Heinrich, Martin [D-NM], Sen. King, Angus S., Jr. [I-ME], Sen. Britt, Katie Boyd [R-AL], Sen. Tuberville, Tommy [R-AL], Sen. Sheehy, Tim [R-MT], Sen. Shaheen, Jeanne [D-NH], Sen. Ossoff, Jon [D-GA]
Recent Actions
- 2025-09-04: Read twice and referred to the Committee on Finance.
- 2025-09-04: Introduced in Senate
Bill Versions
- Fair Access In Residency Act of 2025 — issued 2025-09-04 — PDF (4 pages)