Hope for Hospitals that Inadvertently Triggered GME Caps: Advancing Medical Resident Training in Community Hospitals Act
April 16, 2019
Two US Members of the House of Representatives from Wisconsin reintroduced a bipartisan bill titled Advancing Medical Resident Training in Community Hospital Act on February 26, 2019 (H.R. 1358). The bill introduced by Representatives Ron Kind (D-WI) and Mike Gallagher (R-WI) provides relief for Community hospitals that inadvertently established low permanent full-time equivalent (FTE) resident cap and/or Per Resident Amounts (PRA) by accepting rotating residents from other teaching programs.
The proposed legislation addresses the difficulty hospitals experience in determining whether they are a “new teaching” hospital by accepting rotating residents. The legislation will allow community hospitals to host a small number of resident rotators for short durations without setting a permanent cap or PRA. The legislation addresses the following problems:
• Community Hospitals with FTE cap under 3.0 – Community hospitals who inadvertently were categorized as a “new teaching” hospital by accepting a small number of rotating residents under the current regulations will have a one-time opportunity to increase its FTE cap and PRA. The proposed legislation will apply to community hospitals with FTE caps under 3.0 established after October 1, 1997.
• Hospitals with FTE caps under 1.0 – Any hospitals with a base year FTE cap under 1.0 established under the Balanced Budget Act of 1997 will have an opportunity to establish a new FTE cap and PRA.
• Rotating Residents – Prospectively, any hospital will not “trigger” an FTE cap-building period or be required to establish a PRA unless they train more than 1.0 FTE.
This is not a larger GME reform bill similar to the Resident Physician Shortage Reduction Act of 2019 which we addressed in our March GME Alert Newsletter. However, it is an attempt by our legislator to address the physician shortage problem that we are currently facing.
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