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  • Writer's pictureCapFlexer

The Cap Flex Act Reintroduced in the 117th Congress!

Updated: Jun 23, 2021

Great news!

The Cap Flex Act was re-introduced yesterday, June 17, 2021, in both the House and the Senate by Reps. Raul Ruiz (D-Calif.), Larry Bucshon (R-Ind.), Terri Sewell (D-Ala.) and Brad Wenstrup (R-Ohio).

Also, enclosed is a link to Rep. Ruiz’s press release, which includes quotes from House and Senate sponsors.

See Senator Barrasso's Press Release

See Rep. Wenstrup's Press Release

POLITICO: IS THERE A DOCTOR IN THE HOUSE? — Hospitals in underserved areas would receive more Medicare money to expand their residency programs under a bipartisan proposal from Reps. Raul Ruiz (D-Calif.), Larry Bucshon (R-Ind.), Terri Sewell (D-Ala.) and Brad Wenstrup (R-Ohio). The legislation, which seeks to address a physician shortage that's particularly acute in lower-income and rural communities, would give qualifying hospitals 10 years to build out their residency programs before the Graduate Medical Education residency slots paid for by Medicare are capped, up from five years under current law.

The Association of American Medical Colleges estimates the country could see an estimated shortage of 37,800 to 124,000 physicians by 2034.

"Now more than ever, we must work to address the physician shortage crisis, which most severely impacts underserved and rural communities," Ruiz said.


June 17, 2021

Press Release

Washington, D.C. – Today, Congressman Raul Ruiz, M.D. (D-CA), Rep. Larry Buschon, M.D. (R-IN), Rep. Terri Sewell (D-AL), and Rep. Brad Wenstrup, D.P.M. (R-OH) introduced legislation to grow the physician workforce in underserved and rural areas of the country. The Physician Shortage GME Cap Flex Act of 2021, would address the national physician workforce shortage by empowering new teaching hospitals in underserved areas to increase the number of Medicare-funded residency training slots in their programs. Senators Cortez Masto (D-NV) and Barrasso (R-WY) have introduced companion legislation in the Senate.

“Now more than ever, we must work to address the physician shortage crisis, which most severely impacts underserved and rural communities,” Dr. Ruiz said. “As an emergency physician, I have seen firsthand the pain and suffering of patients who lacked access to nearby physicians. That is why I am introducing the bipartisan, bicameral Physician Shortage GME Cap Flex Act to empower teaching hospitals in underserved communities to help meet the health care needs of people in my district and across the nation.”

“Over the past year, our healthcare system has pushed many physicians to their limit with ever increasing demands that could result in a shortage of quality doctors and threaten the ability of Americans to access quality and affordable healthcare if we don’t act soon – especially in rural America,” said Dr. Bucshon. “This legislation is an important step forward towards addressing our demand for physicians by incentivizing teaching hospitals to stand up residency training programs in primary care or specialties facing shortages to train additional physicians in these areas of need.”

"Our Nation's physician shortage poses a particular threat to our rural and underserved communities here in Alabama," said Rep. Sewell. "By giving rural hospitals the flexibility to build out their GME programs, this bill will help increase the physician workforce in our most vulnerable communities and ensure that my constituents are receiving the high-quality health care they deserve."

“As a physician who has helped start a residency program, I understand the challenges associated with the process but also know the value in providing training opportunities for our nation’s future health care providers,” said Congressman Wenstrup. “That’s why I’m proud to join in introducing this bipartisan bill that will help us address the growing physician shortage by giving hospitals in rural and other underserved areas the flexibility to build out their GME programs. I’m grateful to Representatives Ruiz and Sewell for their leadership and cooperation on this critical effort.”

“We must focus on training the next generation of health care providers,” Barrasso said.

“This is not a partisan issue. Republicans and Democrats agree solutions are needed to meet the critical shortages of physicians facing our country. This situation is especially urgent in rural communities. I am proud to help lead this bipartisan effort to expand physician training in the places and specialties needing it most.”

Currently, teaching hospitals have five years from being established to build out their residency programs before the Graduate Medical Education (GME) residency slots paid for by Medicare – are capped. Under this legislation, the timeframe for qualifying hospitals would double to ten years.


According to the Association of American Medical Colleges (AAMC), the United States could see an estimated shortage of between 37,800 and 124,000 physicians by 2034, including shortfalls in both primary and specialty care.

The COVID-19 pandemic has only further highlighted the need to address the national physician shortage as providers nationwide experienced burnout, which could cause doctors and other professionals to reduce their hours or retire sooner. In fact, even before the COVID-19 pandemic began, 40 percent of practicing physicians felt burned out at least once a week, according to the AAMC.

Under current law, Medicare pays for most residency slots. However, the number of residency slots that Medicare will pay for was capped in 1997, allowing hospitals only five years to build out their new residency programs to qualify for GME funding before they are “capped.”

The Cap Flex Act would allow new teaching hospitals in areas with a specialty shortage (as defined by the Health and Human Services Secretary) an additional five years to further build out their residency program. In deciding which residency programs will qualify, the Secretary will consider various factors, including whether an area lacks adequate resources, is experiencing a primary or specialty physician shortage, or does not have enough approved residency training programs.

The bill would also allow qualifying residency programs that are currently in their original five-year cap building window to have an additional five years to grow their programs before being capped.


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