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Children's Hospital Graduate Medical Education Payment Program (CHGME)


President Obama March 4 released his fiscal year (FY) 2015 budget, which calls for $3.9 trillion in spending.  The budget adheres to the FY 2015 discretionary (appropriated) spending levels agreed to in the Bipartisan Budget Act (P.L. 113-67), which provide less than a $1 billion increase for non-defense programs. Overall, the administration proposes $71.8 billion for discretionary programs under the Department of Health and Human Services (HHS), a decrease of $206 million (0.3 percent) from FY 2014.

The president proposes to eliminate the current $265 million appropriation for the CHGME program in FY 2015. Instead, the administration requests a $100 million set aside for each year in FYs 2015 and 2016 from the proposed new “Targeted Support for Graduate Medical Education Program.


Authorization On October 6, 2006, the President signed into law the Children's Hospital GME Support Reauthorization Act ( P.L. 109-307 PDF External Link). The measure reauthorizes the CHGME program through FY 2011 and includes a provision that all grantees must submit annual reports to the Department of Health and Human Services. Beginning in FY 2008, failure to report will result in a 25 percent reduction of payment. The reports must include:

  • types of residency training programs available at the hospital;
  • the number of training positions for residents, the number of positions recruited to fill, and the number filled;
  • the types of training available to residents related to health care needs of different populations such as the underserved;
  • changes made during the year for the purpose of training residents to care for the underserved and for the improvement of quality and patient safety; and
  • the number of residents who completed their residency and are caring for children in the service area of the hospital or within the state.

On September 20, 2011, the House approved legislation (H.R. 1852) introduced May 11, 2011, by House Energy and Commerce Health Subcommittee Chair Joe Pitts (R-Pa.) and Ranking Member Frank Pallone (D-N.J.) to extend the CHGME program's current authorization for another five years. The Senate Health, Education, Labor, and Pensions (HELP) Committee on September 12, 2011, approved similar legislation (S. 958) introduced May 12, 2011, by Senators Robert Casey (D-Pa.) and Johnny Isakson (R-Ga.). S. 958 awaits consideration by the full Senate.

In a May 24, 2011 letter , the AAMC applauded the bills' sponsors for their efforts to "enable the program to continue to support these activities at institutions across the country." AAMC reiterated  its support in another letter in advance of a July 11, 2011, House Energy and Commerce Health Subcommittee hearing on H.R. 1852.

History The CHGME program is administered by the Health Resources and Services Administration (HRSA). It is funded by appropriations under the Labor-HHS-Education appropriations bill and supports the training of residents in free-standing children's hospitals. The CHGME program was authorized by the Health Research and Quality Act of 1999 and announced in a June 19, 2000, Federal Register notice. The program is designed to help pediatric hospitals, which because of their low Medicare patient volume do not receive significant Medicare direct graduate medical education (DGME) and indirect medical education (IME) payments.

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Tannaz Rasouli
Sr. Director, Public Policy & Strategic Outreach
Telephone: 202-828-0525

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