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AAMC Urges CMS to Rescind Capital IME Elimination in Inpatient Comment Letter

July 2, 2009—In its June 30 comment letter on the Medicare hospital inpatient proposed rule, the AAMC urged the Centers for Medicare and Medicaid Services (CMS) to rescind a regulation that would eliminate capital indirect medical education (IME) payments scheduled to occur on Oct. 1. The elimination would result in approximately $380 million in lost payments to teaching hospitals annually.

In other areas, the AAMC also urged CMS to reduce a proposed 1.9 percent cut to the update factor (as a result of perceived coding improvements). The letter also urges CMS not to finalize a reduction to the "labor-related" share to which a hospital's area wage index applies. Reducing the labor-related share would result in lower payments to most teaching hospitals because of their higher wage index values. The AAMC also opposed the proposal to increase the outlier payment threshold which would reduce outlier payments for teaching hospitals that treat high-cost patients.

On the graduate medical education (GME) front, the AAMC urged CMS to rescind a purported "clarification" of when a residency program is considered "new" when a nonteaching hospital begins training residents and is in the process of establishing its Medicare resident cap level. The letter states that not only is the "clarification" ambiguous, but also that the current regulatory definition - which allows the accrediting bodies to determine when a program is new - is appropriate and should be endorsed by CMS in the final rule.


Karen Fisher, JD
Chief Public Policy Officer
Telephone: 202-828-0412

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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.

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Jason Kleinman
Senior Legislative Analyst, Govt. Relations
Telephone: 202-903-0806