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OIG continues hunt for errant GME payments

Compliance Monitor, April 12, 2006

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The OIG continues to audit hospitals for appropriate graduate medical education (GME) Medicare reimbursements.

Most recently, the OIG recommended that Medical College of Virginia amend its cost report to effectively refund $1.6 million associated with GME costs that the hospital did not incur.

The OIG's objective was to determine whether the hospital included the appropriate number of dental residents in its full-time equivalent (FTE) counts when computing Medicare payments for fiscal years (FY) 2000-2002.

The OIG found that although the hospital appropriately included dental residents in its FTE counts, in FY 2000 the hospital inappropriately included 41.90 direct GME FTEs and 34.07 indirect GME FTEs in the counts without incurring all of the costs of training dental residents in nonhospital sites that year. Because the FY 2000 FTEs were used in the three-year rolling average, the hospital overstated its direct and indirect GME claims by $1.6 million for the audit period.

The OIG also found that the hospital included instructive time (e.g., classroom, time for the residents when working in nonhospital settings).

In addition to filing an amended cost report, the OIG further recommends that the hospital

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