June 3, 2020
CMS has published the FY 2021 Inpatient Prospective Payment Services (IPPS) Proposed Rule on May 29th. In the FY 2021 IPPS proposed rule, CMS addresses changes to closing hospitals and Graduate Medical Education (GME) residency programs that could take effect as soon as October 1, 2020. The proposed rule addresses growing concerns of operational and administrative...Read More
May 21, 2020
On Thursday, May 21, 2020, CMS announced yet another extension due to the COVID-19 Public Health Emergency (PHE). CMS has provided flexibility to teaching hospitals and has stated that teaching hospitals have until October 1, 2020 to submit new or amended Medicare GME affiliation agreements, instead of the July 1, 2020 deadline.
The official announcement can be found...Read More
May 11, 2020
On April 30, 2020, The Center for Medicare & Medicaid Services (CMS) released a new set of waivers aimed at relieving financial pressure on Graduate Medical Education (GME) programs to address the needs of the COVID-19 pandemic.
Following is a summary of waivers directly related to GME Programs:
Temporary Bed Increase Will Not Impact IME Payments
For the...Read More
April 20, 2020
In an April 7th letter to Congress, U.S. Representatives Josh Gottheimer (NJ-5) and Bill Pascrell, Jr. (NJ-9) have requested an increase in Graduate Medical Education (GME) slots for hospitals to be included in the next COVID-19 legislative package.
“This would help alleviate the staffing burden that has plagued so many hospitals across the country, and...Read More
April 2, 2020
CMS recognizes that the current regulation on moonlighting residents will not adequately meet the needs of teaching hospitals during this Public Health Emergency (PHE). The current regulation limits moonlighting to services outside the resident’s approved GME programs to patients in an outpatient department or emergency department of a hospital in which the resident has...Read More
March 31, 2020
CMS released a document outlining temporary regulatory waivers and new rules issued by the Trump Administration to provide the healthcare system with maximum flexibility to respond to the COVID-19 pandemic. The temporary changes will apply immediately for the duration of the emergency declaration. Several of the temporary regulatory changes impact the hospital’s Graduate...Read More
March 24, 2020
Amid the unusual circumstances caused by COVID-19, we understand the concerns many providers have relating to extensions on filing cost reports and resident rotations. To date, there have been no regulation changes or exceptions announced by CMS but we will continue to monitor this closely.
As your news source for everything related to GME Reimbursements, we encourage...Read More
January 14, 2020
Breaking Down the GME Payment: Per Resident Amount explained important factors in the Direct Graduate Medical Education (DGME) payment formula. This article will take a step further and discuss another important factor in the Medicare DGME payment, a hospital’s Medicare utilization.
Medicare DGME Payment Formula
The Medicare DGME payment reimburses teaching...Read More
December 11, 2019
Medicare Graduate Medical Education (GME) regulations have many exceptions and special circumstances hospitals must consider when filing their Medicare cost reports. One special circumstance is when a resident takes a leave of absence.
As explained in IRIS Reporting Breakdown, teaching hospitals are required to submit their Intern and Resident Information System...Read More
November 5, 2019
GME Solutions has over 20 years of experience working with Medicare auditors (i.e. Medicare Administrative Contractors, or MACs). The most common disallowances made by MACs concerning Graduate Medical Education (GME) payments result from resident elective rotations.
What are Elective Rotations?
Elective rotations provide an opportunity for residents to tailor...Read More