H.R. 8235 would update the requirements rural hospitals must meet to receive specific Medicare funding for graduate medical education. The bill would affect which hospitals are eligible to receive such funding but would not change the total amount of funding available. CBO estimates that enacting H.R. 8235 would not affect direct spending or revenues. CBO has not estimated the bill’s effects on spending subject to appropriation. The bill contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act.