1. Short title This Act may be cited as the Rural Physician Workforce Production Act of 2018 . 2. Alternative national per resident payment for residents training in rural training locations (a) In general Section 1886 of the Social Security Act ( 42 U.S.C. 1395ww ) is amended by adding at the end the following new subsection: (u) Alternative national per resident payment amount for residents training in rural training locations (1) In general (A) Establishment The Secretary shall establish a national per resident payment (NPRP) amount for time spent by residents training in rural training locations in accordance with paragraph (2). (B) Election For cost reporting periods beginning on or after the date that is 1 year after the date of enactment of this subsection, an applicable hospital (as defined in paragraph (6)(A)), may elect to receive the payment amount under this subsection for each full-time-equivalent resident in an approved medical residency training program that receives training in a rural training location in accordance with paragraph (2). An applicable hospital may make an election under the preceding sentence regardless of whether the applicable hospital is otherwise eligible for a payment or adjustment for indirect and direct graduate medical education costs under subsections (d)(5)(B) and (h) or section 1814(l), as applicable, with respect to such residents. If the applicable hospital is otherwise eligible for such a payment or adjustment, the national per resident payment amount under this subsection shall be in lieu of such payment or adjustment. (C) Application The provisions of this subsection, or the application of such provisions to an applicable hospital, shall not result in or otherwise effect the following: (i) The establishment of a limitation on the number of residents in allopathic or osteopathic medicine for purposes of subsections (d)(5)(B) and (h) with respect to an approved medical residency training program of an applicable hospital (or be taken into account in determining such