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  • Washington Highlights

    VA Issues Proposed Rule for Pilot Program on GME


    Brad Cunningham, Sr. Regulatory Analyst, Graduate Medical Education

    The Department of Veterans Affairs (VA) published a proposed rule on Feb. 4 for the VA Pilot Program on Graduate Medical Education and Residency (PPGMER). The proposed rule outlines the scope and funding for a pilot program of no fewer than 100 VA GME residency positions at VA-covered facilities that is proposed to sunset on Aug. 7, 2031. The PPGMER was part of several initiatives authorized by the Maintaining Internal Systems and Strengthening Integrated Outside Network (MISSION) Act of 2018 (P.L. 115-182) to improve veterans’ access to care. 

    As part of the pilot program, the MISSION Act authorizes the VA to pay resident stipends and benefits at non-VA facilities along with the educational costs associated with their training, while in the program. The VA is also required to pay certain startup costs of new PPGMER residency programs and those programs must demonstrate that they will be financially stable after cessation of startup funding. 

    The PPGMER will allow the VA to assess alternative methods for funding residents outside of the VA’s current GME structure. The VA will place residents in covered facilities and as part of their training residents may treat non-veteran patients. The law requires prioritization of placement of residents in facilities operated by the Indian Health Service, American Indian tribes, or tribal organizations, as well as certain underserved VA facilities and other covered facilities.

    The VA will evaluate several factors when determining which covered facilities receive residents: the ratio of veterans to VA providers in a county, the range of clinical specialties of VA and non-VA providers in an area, whether a provider in a covered facility is included in a specialty in the most recent VA staffing shortage determination, whether the covered facility is located in a community with an underserved VA facility, if the covered facility is located in a Health Professional Shortage Area, or in a rural or remote area. The VA will also take into consideration other factors like the distance between a covered facility and the closest VA facility, and the ability of the program to maintain a sustainable residency program.

    To implement the PPGMER the VA will issue a request for proposal (RFP) to VA facilities and the VA central office will determine the facilities that will receive residents through the PPGMER. RFPs will be evaluated against the published consideration factors in the RFP.

    Comments on the proposed rule must be received by Apr. 5 and may be submitted through Regulations.gov or mailed to the VA central office.