This bill amends title XVIII (Medicare) of the Social Security Act to require the Centers for Medicare & Medicaid Services (CMS) to increase, for purposes of Medicare payment, the otherwise applicable resident limit for qualifying hospitals. The bill establishes a process for distributing the new residency positions.

The bill eliminates the use of three-year rolling averages with respect to calculating, for purposes of Medicare payment, specified limits on certain new or redistributed residency positions.

With respect to specified hospitals, all of the time spent by an intern or resident in an approved medical residency training program, regardless of setting, shall be counted for purposes of determining a hospital's number of residents.

The bill revises payment rules for graduate medical education (GME) costs with respect to a hospital that establishes a new medical residency training program. With respect to a hospital that has not entered into a GME affiliation agreement, CMS shall establish the hospital's resident amount only after determining that the hospital trains more a specified number of residents. Similarly, CMS shall adjust a hospital's limitation on allopathic and osteopathic residents only after determining that the hospital trains more than a specified number of residents. In specified cases, CMS shall provide a hospital an opportunity to have its resident amount reestablished and its limitation adjustment re-determined.

The bill also revises provisions regarding: (1) aggregation rules relating to resident limits, and (2) the period of board eligibility for residents who change specialties.

CMS shall establish and implement procedures for adjusting a hospital's indirect medical education payments based on specified performance measures.