II 

118TH CONGRESS 

2D SESSION S. 5397 

To amend title XVIII of the Social Security Act to adjust allowable direct 

and indirect costs for nursing and allied health education programs. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 21, 2024 

Ms. KLOBUCHAR (for herself and Mr. TILLIS) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XVIII of the Social Security Act to adjust 

allowable direct and indirect costs for nursing and allied 

health education programs. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Rebuild America’s 

5 Health Care Schools Act of 2024’’. 


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•S 5397 IS

1 SEC. 2. ADJUSTING ALLOWABLE DIRECT AND INDIRECT 

2 COSTS FOR NURSING AND ALLIED HEALTH 

3 EDUCATION PROGRAMS. 

4 (a) IN GENERAL.—Section 1861(v)(1) of the Social 

5 Security Act (42 U.S.C. 1395x(v)(1)) is amended by add6 ing at the end the following new subparagraph: 

7 ‘‘(X)(i) In determining such reasonable costs for 

8 nursing and allied health education furnished by a hos9 pital, beginning with respect to cost reporting periods be10 ginning on or after the date of the enactment of the Re11 build America’s Health Care Schools Act of 2024, the Sec12 retary shall include as reasonable costs all direct and indi13 rect costs incurred by a hospital participating in a nursing 

14 and allied health education program licensed by State law 

15 or accredited by a national or regional professional organi16 zation, including costs that— 

17 ‘‘(I) were directly incurred by the hospital; 

18 ‘‘(II) were allocated to the hospital by a related 

19 entity holding the applicable State license or accredi20 tation by a national or regional professional organi21 zation; or 

22 ‘‘(III) were associated with the training of a 

23 program participant at the hospital or at a related 

24 entity. 


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•S 5397 IS

1 ‘‘(ii) For purposes of clause (i), the term ‘related enti2 ty’ means, with respect to a hospital, any entity that is 

3 related by common ownership or control to— 

4 ‘‘(I) the hospital itself; or 

5 ‘‘(II) an entity— 

6 ‘‘(aa) in which the hospital (or another en7 tity that is a related entity with respect to the 

8 hospital) is the sole corporate member; 

9 ‘‘(bb) that is the sole corporate member of 

10 the hospital; 

11 ‘‘(cc) that is part of the same legal entity 

12 as the hospital; or 

13 ‘‘(dd) that shares a board with the hos14 pital.’’. 

15 (b) ALLOWING HEALTH SYSTEMS AND HOSPITAL16 BASED SCHOOLS TO PROVIDE CLINICAL TRAINING AND

17 SUPPORT.—Not later than 120 days after the date of the 

18 enactment of this section, the Secretary of Health and 

19 Human Services shall issue such rules as are necessary 

20 to carry out the amendments made by subsection (a). 

21 (c) PROHIBITING RECOUPMENT OF CERTAIN COSTS

22 UNDER MEDICARE.— 

23 (1) IN GENERAL.—Beginning on the date of the 

24 enactment of this section, the Secretary of Health 

25 and Human Services may not recoup or reduce payVerDate Sep 11 2014 06:45 Dec 05, 2024 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S5397.IS S5397

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•S 5397 IS

1 ments made to a hospital under part A of title 

2 XVIII of the Social Security Act (42 U.S.C. 1395c 

3 et seq.) for costs related to an approved nursing or 

4 allied health education program that are included on 

5 the Medicare cost report for such hospital if such 

6 costs would be allowable after the amendments made 

7 by subsection (a) take effect. 

8 (2) REFUND OF AMOUNTS RECOUPED.—If, dur9 ing the 6-year period ending on the date of the en10 actment of this section, the Secretary recouped or 

11 reduced payments made to a hospital under such 

12 part A for costs described in paragraph (1), the Sec13 retary shall refund to the hospital the amount so re14 couped or reduced. 

Æ 


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