To amend title XVIII of the Social Security Act to require institutions to include a rotation in geriatric medicine for residents as a condition for payment of direct medical education costs under the medicare program.

Amends title XVIII (Medicare) of the Social Security Act to prohibit recognizing as reasonable costs any amounts for the direct costs of approved educational activities for approved medical residency training programs of a provider unless the provider has in effect: (1) a medical residency training program that includes a rotation in the field of geriatric medicine for all residents other than those being trained in a distinct program of general pediatrics; and (2) a two-year medical fellowship program in the field of geriatric medicine. Directs the Secretary of Health and Human Services to assign to each hospital and skilled nursing facility a number of two-year fellowships that an institution must maintain in order to meet the above requirement.