Our Doctors First Act of 2026
Sponsored By: Representative Steube, W. Gregory [R-FL-17]
Introduced
Summary
Stops Medicare payments for graduate medical education for residents who are not U.S. citizens or nationals. This bill would set citizenship or nationality as the rule for who counts as an intern or resident for Medicare GME payments and create a stepped penalty regime for hospitals and nonhospital providers that knowingly claim payments for non‑citizen residents.
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- Hospitals and other providers would lose Medicare GME payments for residents who are not U.S. citizens or nationals. They would face escalating sanctions, starting with a 25% forfeiture of the payment amount and a $1,000,000 civil penalty for repeat violations.
- Non‑citizen and non‑national medical residents would not be counted for purposes of Medicare GME payments, so Medicare would not pay GME costs attributable to those individuals.
- The rule would apply across the three Medicare GME channels: direct hospital GME payments, indirect medical education costs, and direct payments to nonhospital providers. It would take effect for cost reporting periods beginning 1 year after enactment, with the indirect‑cost counting tied to discharges on or after the first July 1 following that year.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 0 benefits, 1 costs, 0 mixed.
Medicare stops payments for noncitizen residents
This bill would bar Medicare payments for graduate medical education costs tied to residents who are not U.S. citizens or nationals. The ban would start for hospital and nonhospital direct GME cost reporting periods that begin one year after enactment. The bill would also bar counting non-citizen residents for indirect medical education adjustments for discharges on or after the first July 1 after that one-year date. Hospitals and qualified nonhospital providers that submit cost reports counting residents they know or should know are not U.S. citizens would face escalating sanctions: first, a civil penalty equal to 25% of the payment amount tied to those residents; second, a $1,000,000 civil penalty; third, exclusion from GME/IME-related payments for 5 years; and fourth or later, exclusion for 10 years. The bill would use the same notice, appeal, and exclusion procedures that apply to existing Medicare civil money penalties and exclusions.
Sponsors & CoSponsors
Sponsor
Steube, W. Gregory [R-FL-17]
FL • R
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
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