I 
119TH CONGRESS 
1ST SESSION H. R. 1708 
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 HOUSE OF REPRESENTATIVES 
FEBRUARY 27, 2025 
Mr. LAHOOD (for himself, Ms. CRAIG, and Mrs. FISCHBACH) introduced the 
following bill; which was referred to the Committee on Ways and Means 
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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Rebuild America’s 
Health Care Schools Act of 2025’’. 
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SEC. 2. ADJUSTING ALLOWABLE DIRECT AND INDIRECT 
COSTS FOR NURSING AND ALLIED HEALTH 
EDUCATION PROGRAMS. 
(a) IN GENERAL.—Section 1861(v)(1) of the Social 
Security Act (42 U.S.C. 1395x(v)(1)) is amended by add-
ing at the end the following new subparagraph: 
‘‘(X)(i) In determining such reasonable costs for 
nursing and allied health education furnished by a hos-
pital, beginning with respect to cost reporting periods be-
ginning on or after the date of the enactment of the Re-
build America’s Health Care Schools Act of 2025, the Sec-
retary shall include as reasonable costs all direct and indi-
rect costs incurred by a hospital participating in a nursing 
and allied health education program licensed by State law 
or accredited by a national or regional professional organi-
zation, including costs that— 
‘‘(I) were directly incurred by the hospital; 
‘‘(II) were allocated to the hospital by a related 
entity holding the applicable State license or accredi-
tation by a national or regional professional organi-
zation; or 
‘‘(III) were associated with the training of a 
program participant at the hospital or at a related 
entity. 
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‘‘(ii) For purposes of clause (i), the term ‘related enti-
ty’ means, with respect to a hospital, any entity that is 
related by common ownership or control to— 
‘‘(I) the hospital itself; or 
‘‘(II) an entity— 
‘‘(aa) in which the hospital (or another en-
tity that is a related entity with respect to the 
hospital) is the sole corporate member; 
‘‘(bb) that is the sole corporate member of 
the hospital; 
‘‘(cc) that is part of the same legal entity 
as the hospital; or 
‘‘(dd) that shares a board with the hos-
pital.’’. 
(b) ALLOWING HEALTH SYSTEMS AND HOSPITAL- 
BASED SCHOOLS TO PROVIDE CLINICAL TRAINING AND 
SUPPORT.—Not later than 120 days after the date of the 
enactment of this section, the Secretary of Health and 
Human Services shall issue such rules as are necessary 
to carry out the amendments made by subsection (a). 
(c) PROHIBITING RECOUPMENT OF CERTAIN COSTS 
UNDER MEDICARE.— 
(1) IN GENERAL.—Beginning on the date of the 
enactment of this section, the Secretary of Health 
and Human Services may not recoup or reduce pay-
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ments made to a hospital under part A of title 
XVIII of the Social Security Act (42 U.S.C. 1395c 
et seq.) for costs related to an approved nursing or 
allied health education program that are included on 
the Medicare cost report for such hospital if such 
costs would be allowable after the amendments made 
by subsection (a) take effect. 
(2) REFUND OF AMOUNTS RECOUPED.—If, dur-
ing the 6-year period ending on the date of the en-
actment of this section, the Secretary recouped or 
reduced payments made to a hospital under such 
part A for costs described in paragraph (1), the Sec-
retary shall refund to the hospital the amount so re-
couped or reduced. 
Æ 
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