Nevada senators hear bill to create tax credit for donations to graduate medical education

CARSON CITY — The Senate Committee on Revenue and Economic Development heard testimony on Senate Bill 269 on the shortage of physicians and other specialists in Nevada and a proposal to create a tax credit to encourage private donations for graduate medical education.

Senator Robin Titus, sponsor of SB269, told the committee the bill would allow businesses and taxpayers subject to the modified business tax to apply for a credit against that tax for monetary donations to the graduate medical education grant program. "Senate bill 269 seeks to secure reliable and ongoing funding for GME independent of federal resources," Titus said.

The bill as presented would cap eligible credits at $4,000,000 for fiscal year 2027, with that cap increasing by 3% each subsequent fiscal year. The Office of Science, Innovation and Technology would review applications and issue a decision within 20 days; once the program receives funds the office would issue a certificate confirming the credit, and a donor would have 30 days to complete the donation or forfeit the credit. The bill requires the Office of Science, Innovation and Technology to notify the Department of Taxation of approved applications, issued certificates and forfeited claims. Titus said an amendment recommended by the Department of Taxation would set an effective date of July 1, 2026 to avoid programming costs to the department's legacy system.

Supporters said the proposal aims to expand residency and fellowship slots so more medical school graduates can complete the mandatory post‑graduate training that determines where many physicians ultimately practice. "SB269 is not just a legislative proposal, but a vital investment in the health and well‑being of our great state," said Steven Lencioni, a fourth‑year medical student at the University of Nevada, Reno School of Medicine, who testified as a private citizen. He described personal and statewide effects of insufficient residency positions, including that Nevada ranks near the bottom nationally for active physicians, primary care doctors and general surgeons per capita.

Testimony provided cost and capacity context. Dr. Daniel Spogan, who has led residency development in rural Nevada, said it costs about $200,000 per year to educate one resident and $2 million to $3 million to start a new program. Blaine Osborne of Nevada Rural Hospital Partners cited research from the University of Nevada, Reno School of Medicine reporting the state could use roughly 2,500 additional doctors to reach the national average; he said Nevada fills roughly 500 residency slots and is therefore at about 20% of the need.

Hospitals, medical schools, physician groups and community health centers supported SB269 at the hearing. Supporters included UNLV and Touro medical students and faculty, Intermountain Health, Dignity Health St. Rose Dominican, Renown Health, the Nevada Hospital Association, Nevada Rural Hospital Partners, Community Health Alliance, the Nevada Public Health Association and the Nevada State Medical Association.

Opponents raised concerns about using tax credits rather than a budget appropriation. Alexander Marks of the Nevada State Education Association said the bill would reduce state tax revenues by the amount of credits claimed and urged the Legislature to consider a general‑fund appropriation instead. Senator Cruz Crawford and other committee members asked whether the credit model would divert general revenue and whether a single institution could apply for a large share of credits without expanding residency capacity. Fiscal staff and proponents said the credit only reduces modified business tax revenue if donations are actually made and that the program is patterned on an existing education scholarship tax‑credit program that is processed by the Department of Taxation, with applications handled first‑come, first‑served under current practice.

Senator Titus and witnesses said the grant advisory council established by prior legislation would determine how grant dollars are used. Titus said the council includes deans and hospital representatives and will prioritize programs that address statewide clinical needs and rural shortages, and that the intent of SB269 is to create sustained funding that does not revert to the general fund if a residency takes multiple years to stand up.

No committee action or vote on SB269 was taken at the hearing; committee discussion centered on technical questions, fiscal impact and oversight. The hearing record included requests for clarifying language on application limits and safeguards to ensure donations result in demonstrable expansion of GME slots.

Looking ahead, proponents urged the committee to advance the bill to provide an additional funding pathway for residency programs and to reduce the loss of home‑grown medical graduates to other states.