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Graduate Medical Education Slots

Section 1886(h) of the Act, as added by section 9202 of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 (Pub. L. 99-272) and implemented in regulations at existing §§413.75 through 413.83, establish a methodology for determining payments to hospitals for the costs of approved graduate medical education (GME) programs. Section 1886(h)(2) of the Act, as added by COBRA, sets forth a payment methodology for the determination of a hospital-specific, base-period per resident amount (PRA) that is calculated by dividing a hospital's allowable costs of GME for a base period by its number of residents in the base period. The base period is, for most hospitals, the hospital's cost reporting period beginning in FY 1984 (that is, the period of beginning between October 1, 1983, through September 30, 1984). Medicare direct GME payments are calculated by multiplying the PRA times the weighted number of full-time equivalent (FTE) residents working in all areas of the hospital (and non-hospital sites, when applicable), and the hospital's Medicare share of total inpatient days.

Section 1886(h)(4)(F) of the Act established limits on the number of allopathic and osteopathic residents that hospitals may count for purposes of calculating direct GME payments. For most hospitals, the limits were the number of allopathic and osteopathic FTE residents training in the hospital's most recent cost reporting period ending on or before December 31, 1996.

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Disparities In Access To Palliative Care  — Health Affairs
Postgraduate training opportunities for all disciplines involved in providing palliative care, such as graduate medical education slots, should be increased.

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Popular Q&A

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Paying for Graduate Medical Education: Who Bears The Cost Of GME?


Physicians go to med school, which is a grad school, I guess. Then they do residency, which is separate from med school. However, the federal government considers residents students and residency programs are usually done in conjunction with universities and their hospitals. In residency, you are not attending a set of classroom classes, you are not writing papers for professors, you are not performing in a typical school environment. I compare it more to on the job training.

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