GME Alert: Congress Pass COVID-19 Emergency Relief Package
December 23, 2020
On December 21, 2020, Congress passed the Consolidated Appropriations Act, 2021, a $900 billion spending package designed to stabilize the US economy and fund programs to fight COVID-19. This bill, expected to take effect by mid-January if signed by President Trump, contains several important changes related to graduate medical education (GME). Below is a summary of pending GME changes:
Section 126: Distribution of additional residency positions.
An additional 1,000 Medicare GME slots are now available and will be distributed over a 5-year period with no more than 200 slots granted per fiscal year. Hospitals are required to submit an application for each fiscal year a GME slot is to be provided. Hospitals will be notified of approved slots by January 31 of said year and will take effect on July 1. Hospitals are capped at 25 additional slots.
Of the additional slots, 10% are reserved for rural hospitals, hospitals exceeding their current Medicare GME caps, hospitals in states with new medical schools or new branch campuses of medical schools, and hospitals located in health professional shortage areas.
Section 127: Promoting Rural Hospital GME Funding Opportunity.
Beginning October 1, 2022, “separate accreditation” standards are waived for resident programs in rural areas applying for Medicare GME rural training track (RTT) programs. This change provides flexibility for rural hospitals partnering with urban hospitals to address physician workforce needs.
Section 131: Medicare GME treatment of hospitals establishing new medical residency training programs after hosting medical resident rotators for short durations.
Hospitals with small numbers of resident rotators now have a 5-year period to re-establish new Per Resident Amounts (PRA) and GME caps. Hospitals with PRA’s and GME caps based on small numbers of incidental resident rotators are permitted to build and receive Medicare funding for new residency programs:
- Hospital GME caps established with fewer than 3.0 full-time equivalent (FTE) resident rotators from new residency training programs between October 1, 1997, and the date of enactment, are permitted to establish new GME caps under existing cap-building processes for new teaching hospitals.
- Hospitals with PRA’s established with fewer than 3.0 full-time equivalent (FTE) resident rotators from new residency training programs between October 1, 1997, and the date of enactment, would be permitted to establish a new PRA under existing methodologies applicable to new teaching hospitals.
- Any hospital with a base-year GME cap established with fewer than 1.0 (FTE) resident prior to October 1, 1997, would be permitted to establish a new FTE cap.
Additional Medicare provisions can be found in the amended Stimulus Bill: Sec-126-131-BILLS-116HR133SA-RCP-116-68-2