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Washington Highlights

CMS Announces Awardees of Redistributed Resident Slots from Closed Hospitals

February 3, 2012—The Centers for Medicare and Medicaid Services (CMS) Jan. 30 released the agency’s first award of resident cap increases under the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152)’s closed hospital residency slot redistribution program.  CMS redistributed 695 DGME slots and 662 IME slots, effective at various dates.  A total of 63 hospitals are receiving additional slots through this first round of the program.

The closed hospital residency slot redistribution program was required by the ACA, and CMS issued implementing regulations in the Calendar Year (CY) 2011 Outpatient Prospective Payment System (OPPS) Final Rule [see Washington Highlights, Nov. 5, 2010].  Under the program, CMS was required to take all of the DGME and IME residency slots from hospitals that closed on or after March 23, 2008, and permanently redistribute them according to certain criteria.  Prior to the ACA, hospitals that took on displaced residents from closed hospitals could only receive cap slots temporarily until the displaced residents completed their training, but there was no provision for the permanent redistribution of these slots. 

The ACA specified that hospitals in the same geographic region as the closed hospital would receive priority for that closed hospital’s slots.  Among other criteria, CMS also gave a preference in distributing these permanent slots to hospitals that assumed an entire program from the closed hospital; to hospitals that received slots from the closed hospital under a GME affiliation agreement and would use the slots to continue to train at least the number of residents they had trained under the affiliation agreement; and to hospitals that took in residents displaced by the hospital closure and would continue to train residents in the same programs as the displaced residents, even after the displaced residents completed their training. 

The slots redistributed under this program came from 14 hospitals throughout the country that closed between March 23, 2008, and Aug. 3, 2010.  Hospitals in the following states were awarded slots from these 14 closed hospitals: Alabama, Arizona, Connecticut, Georgia, Illinois, Indiana, Michigan, Missouri, New Jersey, New York, North Carolina, Pennsylvania, and South Carolina.  Results of the resident slots redistribution from St. Vincent’s Hospital in New York have not yet been released.


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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
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806