The "FAIR Act of 2025" promotes equitable treatment of osteopathic and allopathic residency candidates by requiring hospitals to report applicant and acceptance data, affirming consideration of both types of medical school graduates, and accepting both COMLEX and USMLE scores, with non-compliance resulting in reduced Medicare payments.
Diana Harshbarger
Representative
TN-1
The FAIR Act of 2025 aims to promote equitable treatment of osteopathic and allopathic medical school graduates in hospital residency programs. It requires hospitals to report data on residency applicants and acceptances from both types of medical schools, and to affirm their consideration of both DO and MD candidates. Hospitals that fail to comply will face a reduction in Medicare payments, and the collected data will be made public. This act does not mandate hospitals to accept students from either type of medical school.
FAIR Act Mandates Hospitals Report DO vs. MD Residency Data; Non-Compliance Risks 2% Medicare Cut Starting 2026
The Fair Access In Residency Act of 2025, or FAIR Act, steps into the world of medical residencies. It amends the Social Security Act to require hospitals running approved medical residency training programs to report specific data to the Secretary of Health and Human Services (HHS). Hospitals will need to disclose the number of applicants and accepted residents from both osteopathic (DO) and allopathic (MD) medical schools for each program. The stated goal is to encourage more equitable treatment for graduates from both types of medical schools during the competitive residency match process.
Shining a Light on Selection
So, what does this actually mean on the ground? Hospitals won't just be crunching numbers. They'll also need to formally affirm two key things: first, that they actually consider applicants from both DO and MD schools, and second, that they accept scores from either the DO licensing exam (COMLEX-USA) or the MD licensing exam (USMLE). Think of it as putting their policies down in writing for Uncle Sam. To make this information accessible, the bill directs HHS to publish all this reported data – the numbers and the affirmations – on a public website. This transparency means prospective residents, educators, and the public could see how different hospital programs stack up in terms of considering DO and MD candidates.
Where Policy Meets the Pocketbook
The FAIR Act isn't just asking nicely. Starting October 1, 2026, hospitals that fail to submit this required information face a penalty: a 2% reduction in their Medicare payments for that year. Given how much hospitals rely on Medicare funding, this penalty provides a significant financial incentive to comply with the reporting requirements. It directly links a hospital's transparency about its residency application process to its bottom line.
The Fine Print: What It Is and Isn't
It's important to note what the bill doesn't do. Section 2 explicitly states this act isn't meant to federalize medical education or force any residency program to accept a specific number or ratio of students from either type of medical school. The focus is squarely on reporting and affirming policies regarding consideration and exam acceptance. The underlying idea seems to be that transparency about application and acceptance rates, combined with the affirmation of fair consideration policies, might naturally encourage more equitable practices without mandating specific outcomes. It aims to give DO graduates potentially facing biases a clearer picture and perhaps a fairer shot based on their qualifications, not just the letters after their name.