HB2314, the Fair Access In Residency Act of 2025 (FAIR Act), would amend the Medicare statute to require hospitals with approved medical residency training programs to report annual data to the Secretary of Health and Human Services about residency applicants and acceptances by medical school type. Specifically, hospitals would have to disclose how many applicants came from osteopathic medical schools and how many came from allopathic medical schools, how many from each group were accepted, and whether the hospital’s policy is to consider both groups for admission.
The bill also requires hospitals that use an exam score as a prerequisite for residency acceptance to accept either the COMLEX-USA or the USMLE, at the applicant’s election. HHS would then publish the submitted information and affirmations on a public website each year beginning with fiscal year 2025. The bill includes a rule of construction stating that it does not federalize medical education or require residency programs to accept any particular number of students from either type of medical school.
Impact
The bill would amend section 1886(d)(5)(B) of the Social Security Act, tying Medicare-related hospital payment reductions to compliance with the new reporting requirement. Beginning with discharges on or after October 1, 2026, hospitals that fail to submit the required information would face a 2 percent reduction for each prior fiscal year of noncompliance, starting with fiscal year 2025. It would affect hospitals with approved medical residency training programs, the Department of Health and Human Services, and applicants from osteopathic and allopathic medical schools by creating a federal transparency regime for residency selection practices.
Sentiment
Based on the bill text and available context, the measure appears to be framed as a fairness and transparency bill rather than a punitive or expansive federal intervention. The bipartisan list of original sponsors suggests broad interest in addressing perceived inequities in residency access for osteopathic applicants. There is no recorded committee debate or vote history in the provided materials, so there is no direct evidence of opposition or support beyond the bill’s sponsorship and its referral to the House Committee on Ways and Means.
Contention
The main point of contention is likely the use of Medicare payment reductions to compel reporting, which could be viewed by hospitals as an indirect federal penalty. Another possible concern is the requirement to publicly report residency applicant and acceptance data by medical school type, which some institutions may see as administratively burdensome or as exposing internal selection practices. The bill anticipates a broader objection by expressly stating that it does not federalize medical education or mandate acceptance of osteopathic or allopathic applicants, indicating sensitivity to concerns about federal overreach and program autonomy.