June 13, 2018:
Congress decided Medicare should pay its share in training our future doctors, at least until the communities were ready to support the programs; over 50 years later, Medicare is still paying its share in the direct and indirect costs for graduate medical education. The rules surrounding this payment are quite complex. In this article, we will be discussing the regulations...Read More
May 9, 2018:
As a result of the U.S. District Court for the District of Columbia’s holding of Banner Heart Hospital v. Burwell, 201 F. Supp. 3d 131 (D.D.C. 2016), CMS issued a favorable ruling for providers on April 23, 2018. CMS Ruling 1727-R states that “for appeals of cost reporting periods that ended on or after December 31, 2008 and began before January 1, 2016 that were pending or filed...Read More
May 1, 2018:
CMS has made available its display version of the FY 2019 IPPS Proposed Rule, which is scheduled to be published on May 7, 2018. There are two Graduate Medical Education issues that we would like to highlight.
Medicare GME Affiliated Group
First, CMS is proposing to allow new urban teaching hospitals (i.e. hospitals that did not have residents in their FY 1996 cost reports) some...Read More
May 1, 2018:
Are you skeptical? Certainly the fiscal intermediary’s auditors are and also current CMS Hospital Payment Policy Staff have confused the matter. But, have heart and claim the costs.
Here’s why! My analysis always begins with evaluating the intent of the Medicare Law. On this issue, the law clearly states that Medicare will share the Hospital’s cost of training. During my tenure...Read More
March 14, 2018:
In order to claim nonprovider locations on your IRIS report, there are several additional rules that you must consider. Our hope for you is that by the end of this article you will be able to identify if a facility is considered a nonprovider location, if the training in which the residents are participating is claimable for GME and IME, and the type of documentation that is...Read More
March 5, 2018:
Reporting vacation time on the IRIS report can be tricky. Medicare regulations state that vacation time or leave of absence can be counted on the IRIS report as long as it does not prolong the total time of the resident’s training (42 CFR § 413.79(h)).
It gets tricky when the resident that is on vacation is spending time in more than one hospital throughout the academic year....Read More