Residency

CMS says capital IME payments can stay

Residency Program Insider, August 11, 2009

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The Centers for Medicare and Medicaid Services (CMS) reinstated the capital indirect medical education (IME) adjustment to payment rates for teaching hospitals. CMS had eliminated these payments effective Oct. 1 2009, but the 2010 Medicare hospital inpatient prospective payment system (IPPS) final rule reversed that action.

Public comments in favor of the payments and updated analysis on cutting the IME payment caused CMS to reverse its decision. The agency predicts that the proposed rule will increase operating payments by $1.73 billion and capital payments by $171 million in FY 2010.

Additionally, the final rule also includes a clarification regarding how new teaching hospitals should establish its resident cap for IME and DGME payments. Accreditation by the appropriate organization has long been the determining factor of whether the program’s residents could be included in the resident cap. In the IPPS, CMS states that it will also look at whether the following is established:

  • New program director
  • New teaching staff
  • New residents in the program
  • Relationship between the hospitals


The agency will also examine the degree to which the hospital with the original program continues to operate its own program in the same specialty, and it will consider whether the new program was relocated from a hospital that closed and whether the program is part of any existing hospital's FTE cap determination.



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