Title: TRAIN Act
Policy area: Health

Summary:
Technical Reset to Advance the Instruction of Nurses Act or the TRAIN Act
This bill modifies the methodology and application of Medicare Advantage nursing and allied health education payments for hospitals. Specifically, for 2010-2019, the bill eliminates the annual cap on total payments and excludes any resulting increase from factoring into calculations for graduate medical education payments for such hospitals. (The Centers for Medicare & Medicaid Services recently issued guidance providing for the recalculation and correction of certain payments to account for the annual payment cap.)

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4407 Introduced in House (IH)]

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117th CONGRESS
  1st Session
                                H. R. 4407

To amend title XVIII of the Social Security Act to provide a waiver of 
  the cap on annual payments for nursing and allied health education 
                               payments.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 13, 2021

 Ms. Blunt Rochester (for herself, Mr. LaHood, and Mr. Rodney Davis of 
  Illinois) introduced the following bill; which was referred to the 
Committee on Ways and Means, and in addition to the Committee on Energy 
    and Commerce, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to provide a waiver of 
  the cap on annual payments for nursing and allied health education 
                               payments.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Technical Reset to Advance the 
Instruction of Nurses Act'' or the ``TRAIN Act''.

SEC. 2. WAIVER OF CAP ON ANNUAL PAYMENTS FOR NURSING AND ALLIED HEALTH 
              EDUCATION PAYMENTS.

    (a) In General.--Section 1886(l)(2)(B) of the Social Security Act 
(42 U.S.C. 1395ww(l)(2)(B)) is amended--
            (1) by striking ``payments.--Such ratio'' and inserting 
        ``payments.--
                            ``(i) In general.--Subject to clause (ii), 
                        such ratio''; and
            (2) by adding at the end the following new clause:
                            ``(ii) Exception to annual limitation for 
                        each of 2010 through 2019.--For each of 2010 
                        through 2019, the limitation under clause (i) 
                        on the total amount of additional payments for 
                        nursing and allied health education to be 
                        distributed to hospitals under this subsection 
                        for portions of cost reporting periods 
                        occurring in the year shall not apply to such 
                        payments made in such year.''.
    (b) No Affect on Payments for Direct Graduate Medical Education.--
Section 1886(h)(3)(D)(iii) of the Social Security Act (42 U.S.C. 
1395ww(h)(3)(D)(iii)) is amended by adding at the end the following 
sentence: ``In applying the preceding sentence for each of 2010 through 
2019, the Secretary shall not take into account any increase in the 
total amount of such additional payment amounts for such nursing and 
allied health education for portions of cost reporting periods 
occurring in the year pursuant to the application of paragraph 
(2)(B)(ii) of such subsection.''.
    (c) Retroactive Application.--The amendments made by this section 
shall apply to payments made for portions of cost reporting periods 
occurring in 2010 and subsequent years.
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