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  • Washington Highlights

    Bipartisan GME Expansion Legislation Reintroduced in the House

    Allyson Perleoni, Director, Government Relations
    Len Marquez, Senior Director, Government Relations

    Representatives Terri Sewell (D-Ala.) and John Katko (R-N.Y.) March 14 introduced the “Resident Physician Shortage Reduction Act of 2019,” bipartisan legislation aimed at addressing the looming physician shortage by increasing the number of Medicare-supported graduate medical education (GME) residency positions. Companion legislation was introduced in the Senate Feb. 6 by Sens. Menendez, Boozman, and Democratic Leader Schumer [see Washington Highlights, Feb. 8]

    In a March 14 statement, AAMC President and CEO Darrell G. Kirch, MD, commended the members’ leadership, stating, “This targeted bipartisan legislation, along with companion legislation introduced in the Senate last month, takes a much needed step towards ensuring that all Americans will have access to the doctors they need. However, this will not relieve the doctor shortage completely. Additional funding is just one piece of a multipronged approach to address the impending shortfall that also includes investment in innovations in care delivery led by the nation’s medical schools and teaching hospitals.”

    The legislation would increase the number of Medicare-supported GME training positions by 3,000 per year over 2021-2025, totaling 15,000 new positions. The legislation sets forth a distribution methodology for the allocation of the additional slots. One-third of the new slots are available only to teaching hospitals training over their cap. In determining which hospitals will receive slots, the Centers for Medicare and Medicaid Services (CMS) is required to consider the likelihood of a teaching hospital filling the positions, and will allocate the slots in the following manner:

    • First, to hospitals in states with new medical schools or new branch campuses;
    • Second, to hospitals affiliated with Veterans Affairs medical centers;
    • Third, to hospitals that emphasize training in community-based settings or in hospital outpatient departments;
    • Fourth, to hospitals that are not located in a rural area and operate an approved “rural track” program; and
    • Fifth, to all other hospitals.

    Hospitals receiving additional slots must ensure that at least 50% of the additional slots are used for a shortage specialty residency program, that the total number of slots is not reduced prior to the increase, and that the ratio of residents in a shortage specialty program is not decreased prior to the increase. A hospital may not receive more than 75 slots in any fiscal year.

    Rep. Sewell issued a press release stating, “This week, medical students across the country will celebrate their match into physician residency programs, but many of their peers will be left without a residency due to the gap between students applying and the number of funded positions. At the same time, the United States faces a projected shortage of up to 120,000 physicians by 2030. We need to act now to train more qualified doctors. Increasing the number of Medicare-supported residency positions means increasing the number of trained doctors to meet growing demand.”

    Rep. Katko added, “I’m proud to introduce this bipartisan measure to help hospitals in Central New York and nationwide recruit and retain medical residents. Our nation faces a dire physician shortage, and we need to do more to allow teaching hospitals and academic medical centers to train more healthcare professionals. This measure adds more residency spots to Medicare’s Graduate Medical Education (GME) program to train emerging physicians and ensure communities nationwide have better access to care.”