Fiscal Year 1998 Prospective
Payment System: Final Rule
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Related Resources
AAMC Documents
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Current Status as of September 1, 1998
On May 12, 1998 the Health
Care Financing Administration (HCFA) published a rule
that contains the final regulations for many of the graduate
medical education provisions included in the Balanced Budget
Act of 1997 (BBA). This rule contains HCFA's replies to the
comments it received in response to the August 29, 1997 interim
final rule, primarily related to the limitation on the number
of residents which Medicare will count for direct and indirect
graduate medical education provisions ("resident limits
or caps"). The AAMC has prepared a detailed summary
and analysis of the final rule.
Summary
The regulations govern both indirect medical education (IME)
and direct graduate medical education (DGME) payments. The
May 12, 1998 rule contains comments submitted in response
to the August 29, 1997 interim final rule. HCFA modified several
provisions that were part of the August 29 publication. These
modifications will help institutions trying to operate within
the resident limits. They include:
- increasing the flexibility for hospitals that wish to
aggregate their resident limits by allowing program affiliations
and broadening the geographic areas to include contiguous
areas;
- broadening the definition of "new residency program"
to include training programs that received initial accreditation
OR began training residents on or after January 1, 1995;
and
- permitting the resulting entity of a merger to have a
cap that is an aggregate of the participating hospitals'
caps.
At the same time, the final rule was not modified to reflect
comments on other issues, such as expanding existing programs
and modifying resident limits to address downsizing decisions
by VA hospitals.
The summary and analysis document
prepared by the AAMC contains detailed information on the
regulatory requirements related to resident limits, 3-year
rolling average, resident limit affiliation agreements, and
new residency programs.
AAMC Action
The AAMC submitted comments on the August 29, 1997 interim
final rule. The AAMC has also prepared a summary
and analysis of the regulations.
Contacts
Robert Dickler, Chief Health Care Officer
AAMC Health Care Affairs
rdickler@aamc.org
(202) 828-0490 |
Karen Fisher, Sr. Director, Health Care Affairs
AAMC Health Care Affairs
kfisher@aamc.org
(202) 862-6140
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The May 12, 1998 final rule is available in text format and
Portable Document Format (PDF):
42 CFR Parts 410 et al.
Medicare Program: Changes to the Hospital Inpatient Prospective
Payment Systems and Fiscal Year 1998 Rates; Final Rule
pp. 26317-26360
The August 29, 1997 interim final rule is available in
four parts in text format and Portable Document Format (PDF):
42 CFR Parts 400, 409, et al.
Medicare Program; Changes to the Hospital Inpatient Prospective
Payment Systems and Fiscal Year 1998 Rates; Interim Final
Rule
- Part I [pp. 45966-46015]: Text
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- Part II [pp. 46016-46066]: Text
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- Part III [pp. 46066-46116]: Text
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- Part IV [pp. 46116-46140]: Text
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