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Final rule on didactic time could change everything

Health Care Auditing Strategies, August 1, 2006

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by Christopher L. Francazio, principal, Hinckley, Allen & Tringale, Boston

This month-despite objections from the academic and teaching community-CMS is poised to shake the foundation on which hospitals are paid for graduate medical education (GME). Unfortunately, there isn't much anyone can do about it.

Until now, hospitals have received direct and indirect medical education (DME/IME) reimbursement for time that interns, residents, and fellows spend in hospitals engaged in scholarly or "didactic" activities (e.g. a journal club or conferences). CMS has generally paid these costs, but this month it may approve a final rule that would eliminate IME funding for all didactic time performed in hospitals. Further, if didactic time is performed in a nonhospital setting, then both DME and IME will be eliminated.

Through this rule, CMS says it is simply "clarifying" its policy regarding counting nonpatient activities in both hospital and nonhospital settings. CMS argues that this has always been the rule, stating that IME reimbursement can be claimed only for "patient-care activities." However, CMS has paid-and has been willing to pay-IME reimbursement for didactic activities in the past.

This is an excerpt from a member only article. To read the article in its entirety, please login.

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