Supporting new, expanding, and existing rural training tracks

(a) Direct graduate medical education Section 1886(h) of the Social Security Act (42 U.S.C. 1395ww(h)) is amended— (1) in paragraph (4)— (A) in subparagraph (F)(i)— (i) by striking 130 percent and inserting for cost reporting periods beginning on or after October 1, 1997, and before the date that is 1 year after the date of enactment of the Rural Physician Workforce Production Act of 2025, 130 percent; and (ii) by adding at the end the following: For cost reporting periods beginning on or after the date that is 1 year after the date of enactment of the Rural Physician Workforce Production Act of 2025, such rules shall provide that any full-time-equivalent resident in an approved medical residency program (or separately defined track within a program) that provides more than 50 percent of the total residency training time in rural training locations (as defined in subsection (u)(6)(C)), regardless of where the training occurs and regardless of specialty, shall not be taken into account for purposes of applying the limitation under this subparagraph.; and (B) in subparagraph (H)— (i) in clause (i), in the second sentence, by inserting the following before the period:, in accordance with the second sentence of clause (i) of such subparagraph; and (ii) in clause (iv), by inserting the following before the period:, in accordance with the second sentence of clause (i) of such subparagraph; and (2) in paragraph (5), by adding at the end the following new subparagraph: (L) Special rules regarding application of elective rural sustainability per resident payment amount For special rules regarding application of the elective rural sustainability per resident payment amount under subsection (u), see paragraph (3) of such subsection.. (b) Indirect medical education Section 1886(d)(5)(B)(v) is amended— (1) by striking 130 percent and inserting for cost reporting periods beginning on or after October 1, 1997, and before the date that is 1 year after the date of enactment of the Rural Physician Workforce Production Act of 2025, 130 percent; and (2) by adding at the end the following: For cost reporting periods beginning on or after the date that is 1 year after the date of enactment of the Rural Physician Workforce Production Act of 2025, such rules shall provide that any full-time-equivalent resident in an approved medical residency program (or separately defined track within a program) that provides more than 50 percent of the total residency training time in rural training locations (as defined in subsection (u)(6)(C)), regardless of where the training occurs and regardless of specialty, shall not be taken into account for purposes of applying the limitation under this subparagraph. For special rules regarding application of the elective rural sustainability per resident payment amount under subsection (u), see paragraph (3) of such subsection..