Corporate Compliance

OIG: Connecticut hospital correctly accounted for dental residents

Healthcare Auditing Weekly, December 27, 2005

John Dempsey Hospital of Farmington, CT correctly accounted for dental residents in full-time equivalent (FTE) counts for Medicare graduate medical education (GME) payments, according to an OIG audit.

The audit covered GME payments for fiscal years 2000 through 2002.

The OIG conducted the Dempsey Hospital audit as part of a 10-hospital review checking compliance with the Balanced Budget Act of 1997. The act placed some controls on the continuing growth of GME reimbursement by imposing caps on the number of residents that hospitals are allowed to count for the purpose of direct and indirect GME payments. Dental FTEs are not included in the caps.

The legislation also created incentives for hospitals to train residents in freestanding nonhospital settings, such as clinics and ambulatory surgical centers, by permitting hospitals to count FTE residents who train in nonhospital settings in their calculations of indirect and to direct GME payments.

The OIG is reviewing 10 hospitals to determine the effect of the Balanced Budget Act on direct and indirect GME payments for dental residents included in hospitals' counts of FTE residents.

To complete the audit, the OIG

  • reviewed applicable federal criteria, including section 1886 of the Social Security Act and 42 CFR parts 412 and 413

  • gained an understanding of the hospital's procedures for identifying, counting, and reporting dental resident FTEs on Medicare cost reports

  • reconciled the dental resident FTEs reported on the hospital's FYs 2000 through 2002 Medicare cost reports to supporting documentation

  • reviewed supporting documentation to determine whether the hospital appropriately included dental residents in the FTE resident counts when computing direct and indirect GME payments on the Medicare cost reports

  • reviewed financial records at the hospital and the dental school to determine whether the hospital incurred all of the costs of training dental residents in nonhospital settings

      Click here to read the audit report, "Graduate Medical Education for Dental Residents Claimed by John Dempsey Hospital for Fiscal Years 2000 Through 2002," (A-04-04-06010) issued November 14, 2005.

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