Rep. Steube Introduces Two Bills Targeting Transparency and Noncitizen Participation in Medicare-Funded Residency Programs

WASHINGTON - U.S. Representative Greg Steube (R-Fla.) today introduced the GME Transparency Act of 2026 and the Our Doctors First Act of 2026, a two-bill package focused on increasing transparency in Medicare-funded graduate medical education (GME) programs and prohibiting Medicare GME payments attributable to individuals who are not U.S. citizens or nationals.

"Taxpayers deserve transparency on how federal healthcare dollars are being spent, especially when billions in Medicare funding are going toward GME programs," said Rep. Greg Steube. "Congress has a responsibility to know who is benefiting from these taxpayer-funded programs and to ban Medicare GME payments from being used to support residency training for foreign nationals."

The GME Transparency Act of 2026 would require hospitals participating in the Medicare-funded GME programs to submit deidentified information regarding the citizenship and immigration status of the medical residents in approved residency training programs. Under this bill, a hospital residency program would not be treated as an approved program for Medicare payment purposes if the required information is not submitted. The legislation also requires CMS to submit an annual nationwide report to Congress detailing aggregate residency data by state, including U.S. citizens, green card holders, J-1 visa holders, H-1B visa holders, and other lawfully present medical residents.

The Our Doctors First Act of 2026 would prohibit Medicare-funded GME payments from being used to support residency training costs associated with individuals who are not U.S. citizens or nationals. Hospitals and qualified nonhospital providers that count noncitizen medical residents for payment purposes where they know or should know the individuals are not U.S. citizens or nationals would face escalating penalties, including civil monetary penalties and exclusion from receiving GME payments for repeat violations.

Background: Graduate medical education (GME) is residency training completed by physicians after medical school. Medicare supports teaching hospitals that operate GME programs through direct graduate medical education (DGME) and indirect medical education (IME) payments. DGME payments help cover residency training costs such as resident stipends, supervisory physician salaries, and administrative expenses, while IME payments help offset the higher operational costs associated with teaching hospitals.

Medicare spends billions of dollars annually supporting graduate medical education programs intended to strengthen America's physician workforce.

Meanwhile, American medical school graduates are burdened with significant student debt as communities across the country continue facing physician shortages.

The American taxpayer is already footing the bill for these programs, and lawmakers are increasingly raising concerns about whether taxpayer dollars are being used to support residency training for foreign nationals rather than American physicians.

Read the bill text here.