S. 1087 — Rebuild America’s Health Care Schools Act of 2025

This section amends the Medicare statute governing reasonable costs for inpatient hospital services (42 U.S.C. 1395x(v)(1)) by adding a new subparagraph (X) to require, for hospital cost reporting periods beginning on or after enactment of the Rebuild America’s Health Care Schools Act of 2025, inclusion of specified direct and indirect costs as reasonable costs for state-licensed or nationally or regionally accredited nursing and allied health education programs. (These costs include those directly incurred by the hospital; allocated by a related entity (i.e., one under common ownership or control, or with specified corporate membership ties to the hospital); associated with participant training at the hospital or related entity; tied to faculty contracts with non-related educational institutions; or involving shared services such as payroll from related entities.) The section further (1) directs the Secretary of Health and Human Services to issue implementing rules within 120 days of enactment; and (2) prohibits, upon enactment, recoupment or reduction of Medicare Part A payments for such costs reported on hospital cost reports that would be allowable under the new rules, with refunds required for amounts recouped in the prior six years. (As background, Medicare reimburses hospitals for reasonable costs of inpatient services furnished to beneficiaries, including certain graduate medical education costs; this expands reimbursable costs for nursing and allied health programs—which train nurses, technicians, and similar professionals—to address prior limitations on indirect and related-entity costs.)