HouseH.R. 8943119th Congress
Our Doctors First Act of 2026
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[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8943 Introduced in House (IH)]
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119th CONGRESS
2d Session
H. R. 8943
To amend title XVIII of the Social Security Act to prohibit payments
for graduate medical education costs attributable to individuals who
are not citizens or nationals of the United States under the Medicare
program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 20, 2026
Mr. Steube 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 prohibit payments
for graduate medical education costs attributable to individuals who
are not citizens or nationals of the United States under the Medicare
program.
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 ``Our Doctors First Act of 2026''.
SEC. 2. PROHIBITING FEDERALLY-FUNDED GRADUATE MEDICAL EDUCATION FOR
NON-CITIZENS UNDER MEDICARE.
(a) Hospital Payments for Direct Graduate Medical Education
Costs.--Section 1886(h) of the Social Security Act (42 U.S.C.
1395ww(h)) is amended--
(1) in paragraph (1), by inserting ``, subject to paragraph
(11)'' after ``of this subsection'';
(2) in paragraph (4), by adding at the end the following
new subparagraph:
``(L) Non-citizen residents.--Such rules shall
provide that, effective for cost reporting periods
beginning on or after the date that is 1 year after the
date of the enactment of this subparagraph, an
individual shall not be counted as a resident unless
such individual is a citizen or national of the United
States.''; and
(3) by adding at the end the following new paragraph:
``(11) Sanctions for counting non-citizen residents.--
``(A) In general.--Effective for cost reporting
periods beginning on or after the date that is 1 year
after the date of the enactment of this paragraph, a
hospital that submits a cost report counting 1 or more
individuals who such hospital knows or should know are
not citizens or nationals of the United States as
interns or residents for purposes of payment under this
subsection in violation of paragraph (4)(L) or payment
under paragraphs (5)(B) and (11) of subsection (d) in
violation of subsection (d)(5)(B)(xiv) shall be subject
to the following sanctions:
``(i) In the case of the first cost
reporting period for which such hospital
submits such a cost report, a civil monetary
penalty equal to 25 percent of the payment
amount that would be attributable to the
individuals so counted pursuant to such cost
report if such individuals were permitted to be
so counted under this subsection and subsection
(d)(5)(B).
``(ii) In the case of the second cost
reporting period for which such hospital
submits such a cost report, a civil monetary
penalty equal to $1,000,000.
``(iii) In the case of the third cost
reporting period for which such hospital
submits such a cost report, such hospital shall
be excluded from receiving payments under this
subsection and paragraphs (5)(B) and (11) of
subsection (d) for a period of 5 years.
``(iv) In the case of each subsequent cost
reporting period for which such hospital
submits such a cost report, such hospital shall
be excluded from receiving payments under this
subsection and paragraphs (5)(B) and (11) of
subsection (d) for a period of 10 years.
``(B) Procedures.--
``(i) Civil monetary penalties.--The
provisions of section 1128A (other than
subsection (a) and (b) of such section) shall
apply to civil monetary penalties under this
paragraph in the same manner as such provisions
apply to a penalty or proceeding under
subsection (a) of such section.
``(ii) Exclusion from payments.--The
provisions of subsections (c)(1) and (f) of
section 1128 shall apply to an exclusion from
receiving payments under this paragraph in the
same manner as such provisions apply to
exclusions from participation under such
section.''.
(b) Hospital Payments for Indirect Costs of Medical Education.--
Section 1886(d) of the Social Security Act (42 U.S.C. 1395ww(d))--
(1) in paragraph (5)(B)--
(A) by striking ``The Secretary'' and inserting
``Subject to subsection (h)(11), the Secretary''; and
(B) by adding at the end the following new clause:
``(xiv) For discharges occurring on or after the first July
1 occurring on or after the date that is 1 year after the date
of the enactment of this clause, an individual shall not be
counted as an intern or a resident under this subparagraph
unless such individual is a citizen or national of the United
States.''; and
(2) in paragraph (11)(A), by inserting ``subject to
subsection (h)(11),'' before ``the Secretary''.
(c) Nonhospital Provider Payments for Direct Costs of Medical
Education.--Section 1886(k) of the Social Security Act (42 U.S.C.
1395ww(k)) is amended by adding at the end the following new paragraph:
``(3) Non-citizen residents.--
``(A) In general.--Effective for cost reporting
periods beginning on or after the date that is 1 year
after the date of the enactment of this paragraph,
payment may not be made under this subsection for
direct costs of medical education incurred with respect
to residents who are not citizens or nationals of the
United States.
``(B) Penalties.--
``(i) In general.--Effective for cost
reporting periods beginning on or after the
date that is 1 year after the date of the
enactment of this paragraph, a qualified
nonhospital provider that submits a cost report
requesting payment under this subsection for
direct costs of medical education incurred with
respect to 1 or more residents who such
qualified nonhospital provider knows or should
know are not citizens or nationals of the
United States in violation of subparagraph (A)
shall be subject to the following sanctions:
``(I) In the case of the first cost
reporting period for which such
qualified nonhospital provider submits
such a cost report, a civil monetary
penalty equal to 25 percent of the
payment amount requested pursuant to
such cost report for direct costs of
medical education incurred with respect
to such residents.
``(II) In the case of the second
cost reporting period for which such
qualified nonhospital provider submits
such a cost report, a civil monetary
penalty equal to $1,000,000.
``(III) In the case of the third
cost reporting period for which such
qualified nonhospital provider submits
such a cost report, such qualified
nonhospital provider shall be excluded
from receiving payments under this
subsection for a period of 5 years.
``(IV) In the case of each
subsequent cost reporting period for
which such qualified nonhospital
provider submits such a cost report,
such qualified nonhospital provider
shall be excluded from receiving
payments under this subsection for a
period of 10 years.
``(ii) Procedures.--
``(I) Civil monetary penalties.--
The provisions of section 1128A (other
than subsection (a) and (b) of such
section) shall apply to civil monetary
penalties under this subparagraph in
the same manner as such provisions
apply to a penalty or proceeding under
subsection (a) of such section.
``(II) Exclusion from payments.--
The provisions of subsections (c)(1)
and (f) of section 1128 shall apply to
an exclusion from receiving payments
under this subparagraph in the same
manner as such provisions apply to
exclusions from participation under
such section.''.
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