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CMS Responds to Grassley GME Inquiry

January 24, 2020

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

The Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma Jan. 6 responded to an Oct. 2019 inquiry from Finance Committee Chairman Chuck Grassley (R-Iowa) seeking information on various federal Graduate Medical Education (GME) programs [see Washington Highlights, Oct. 18 2019].

The initial letter to U.S. Department of Health and Human Services (HHS) Secretary Alex Azar asked him to provide information on how GME dollars are spent, as well as what oversight the agency performs to prevent waste, fraud, and abuse in the program. Specifically, the Chairman’s letter contained a dozen questions regarding the GME program. Responses were requested by Oct. 31.

The Senate Finance Committee Jan. 23 released the Jan. 6 response from Administrator Verma. The response addressed some of the Chairman’s GME oversight questions, specifically focusing on:

  • Highlighting administrative action taken by the Administration to combat fraud, waste, and abuse in the Medicare program.
  • Detailing the Administration’s Fiscal Year (FY) 2020 budget proposal to consolidate Medicare GME, Medicaid GME, and the Children's Hospital GME (CHGME) Program funding into a single grant program funded out of the general fund of the Treasury [see Washington Highlights, March 15, 2019]. The Administrator acknowledged enacting this proposal would require legislative action.
  • Explaining CMS’ use of Medicare Administrative Contractors (MACs) to process and audit payments for health care items and services submitted by teaching hospitals (including GME payments) on their annual cost reports and to audit the number of resident FTEs that hospitals report on their annual cost report by reviewing relevant rotation schedules.
  • Describing how CMS avoids duplicate payments for residents by requiring teaching hospitals to submit Intern and Resident Information System (IRIS) files as part of their cost reports.

The accompanying Committee press release noted that Verma indicated that “significant changes to the program would require legislative action in Congress.”

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