,,ii  #aahth ,,congress  #b;d ,session  
,s4 #ecig  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,november #ba1 
#bjbd,ms4 ,klobuchar 7for herself and   
,mr4 ,tillis7 introduced the following  
bill2 which was read twice and referred 
to the ,committee on ,finance  ,a ,,bill
  ,to amend title ,,xviii of the ,social
 ,security ,act to adjust allowable     
direct and indirect costs for nursing   
and allied health education programs4   
#a4 ,short title ,this ,act may be cited
 as the ,rebuild ,america's ,health     
,care ,schools ,act of #bjbd4  #b4      
,adjusting allowable direct and indirect
 costs for nursing and allied health    
education programs  7a7 ,in general     
,section #ahfa7v77#a7 of the ,social    
,security ,act 7#db ,u4,s4,c4           
#aciex7v77#a77 is amended by adding at  
the end the following new subparagraph3 
7,x7 7i7 ,in determining such reasonable
 costs for nursing and allied health    
education furnished by a hospital1      
beginning with respect to cost reporting

 periods beginning on or after the date 
of the enactment of the ,rebuild        
,america's ,health ,care ,schools ,act  
of #bjbd1 the ,secretary shall include  
as reasonable costs all direct and      
indirect costs incurred by a hospital   
participating in a nursing and allied   
health education program licensed by    
,state law or accredited by a national  
or regional professional organization1  
including costs that-- 7,i7 were        
directly incurred by the hospital2      
7,,ii7 were allocated to the hospital by
 a related entity holding the applicable
 ,state license or accreditation by a   
national or regional professional       
organization2 or  7,,iii7 were          
associated with the training of a       
program participant at the hospital or  
at a related entity4  7ii7 ,for purposes
 of clause 7i71 the term related entity 
means1 with respect to a hospital1 any  
entity that is related by common        
ownership or control to-- 7,i7 the      
hospital itself2 or  7,,ii7 an entity-- 

7aa7 in which the hospital 7or another  
entity that is a related entity with    
respect to the hospital7 is the sole    
corporate member2  7bb7 that is the sole
 corporate member of the hospital2  7cc7
 that is part of the same legal entity  
as the hospital2 or  7dd7 that shares a 
board with the hospital4  4  7b7        
,allowing health systems and            
hospital-based schools ,to provide      
clinical training and support ,not later
 than #abj days after the date of the   
enactment of this section1 the          
,secretary of ,health and ,human        
,services shall issue such rules as are 
necessary to carry out the amendments   
made by subsection 7a74  7c7            
,prohibiting recoupment of certain costs
 under ,medicare  7#a7 ,in general      
,beginning on the date of the enactment 
of this section1 the ,secretary of      
,health and ,human ,services may not    
recoup or reduce payments made to a     
hospital under part ,a of title ,,xviii 
of the ,social ,security ,act 7#db      

,u4,s4,c4 #acie;c et seq47 for costs    
related to an approved nursing or allied
 health education program that are      
included on the ,medicare cost report   
for such hospital if such costs would be
 allowable after the amendments made by 
subsection 7a7 take effect4  7#b7       
,refund of amounts recouped ,if1 during 
the #f-year period ending on the date of
 the enactment of this section1 the     
,secretary recouped or reduced payments 
made to a hospital under such part ,a   
for costs described in paragraph 7#a71  
the ,secretary shall refund to the      
hospital the amount so recouped or      
reduced4