FAIR Act of 2025
The FAIR Act of 2025 (S. 2715) would revise Medicare rules to mandate greater transparency and equity in residency program admissions between osteopathic (DO) and allopathic (MD) candidates. Hospitals with approved residency programs would have to report annually to the Secretary of Health and Human Services data on residency applicants and acceptances broken out by the applicant’s medical school type (osteopathic vs allopathic), and include an affirmation that both groups are considered and that applicants’ licensing exam scores from either the COMLEX-USA or USMLE are accepted if the hospital requires scores. HHS would publicly publish this information for each fiscal year (starting with FY 2025). In addition, beginning with discharges after October 1, 2026, Medicare payments to a hospital could be reduced by 2 percent for each prior fiscal year (starting with FY2025) in which the hospital did not submit the required information. The bill carries a construction clause stating it does not federalize medical education or mandate accepting a specific number of DO or MD students.
Key Points
- 1Reporting requirement: Hospitals with approved residency programs must submit to HHS the number of residency applicants and those accepted from both osteopathic and allopathic medical schools for each program and fiscal year, starting with FY 2025.
- 2Licensing exam flexibility: The information must affirm that the hospital considers applicants from both DO and MD schools and accepts exam scores from either COMLEX-USA or USMLE if exam scores are used.
- 3Public publication: HHS must publish on a public website the reported applicant/acceptance data and the hospital’s affirmation for each fiscal year.
- 4Payment withhold/adjustment: For discharges occurring on or after October 1, 2026, the Medicare payment amount to a hospital for the prior year can be reduced by 2 percent for each prior fiscal year (starting with FY2025) in which the hospital did not submit the required information.
- 5Policy scope and limits: The bill explicitly states it does not federalize medical education or mandate that residency programs must accept a certain number of DO or MD students.