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  • Washington Highlights

    AAMC Endorses Medicare Cap Relief for Certain VA Affiliates

    Matthew Shick, Sr. Director, Gov't Relations & Regulatory Affairs

    AAMC President and CEO Darrell G. Kirch, M.D., July 31 sent a letter  to Sen. John Tester (D-Mont.) endorsing the Senator’s proposal to expand Medicare funding for Graduate Medical Education (GME) under the “Delivering Opportunities for Care and Services (DOCs) for Veterans Act” (S. 1676).  If passed, the bill would allow teaching hospitals at or above their Medicare GME cap to receive additional Medicare support for residents who rotate through Veterans Affairs (VA) positions created under the Veterans Access, Choice, and Accountability Act of 2014 (VACAA, P.L. 113-146) [see Washington Highlights, June 19].

    In the letter, Dr. Kirch notes, “VA physician shortages are symptomatic of a broader trend, the proverbial ‘canary in the coal mine.’” While VACAA “instructs VA to add 1,500 GME residency slots over five years at VA facilities that are experiencing shortages,” the letter cautions, “simply increasing VA GME funding alone will not address the VA crisis.” Dr. Kirch explains that “VA residency programs rely upon the existing administrative and training infrastructure maintained by the nation’s medical schools and teaching hospitals,” and “[w]ithout a corresponding increase in Medicare GME support, VA medical centers will be unable to capitalize fully on increases in VA GME funding.”

    Meanwhile, Sen. Tester offered and withdrew his legislative language at a July 22 Senate VA Committee business meeting. He stated, “Because of the current cap on Medicare funded residency positions, the VA’s effort to carry out the Choice Act provision to establish up to 1,500 additional residencies has been impeded.” He concluded, “Look, I don’t care if you’re in the VA or in the private sector, we don’t have enough docs.” In response, Senate VA Committee Chair Johnny Isakson (R-Ga.) indicated he would be happy to work with Sen. Tester on this issue.