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CMS Announces Fourth and Fifth Round Awardees of Redistributed Resident Slots from Closed Hospitals

January 31, 2014The Centers for Medicare and Medicaid Services (CMS) Jan. 30 released two new rounds of awardees of resident cap increases under the Affordable Care Act’s (ACA, P.L. 111-148 and P.L. 111-152) closed hospital residency slot redistribution program. CMS redistributed 83 Direct Graduate Medical Education (DGME) slots and 76 Indirect Medical Education (IME) slots from closed hospitals Peninsula Hospital Center in Far Rockaway, N.Y. (Round 4), Infirmary West Hospital in Mobile, Ala. (Round 5), and Montgomery Hospital in Norristown, Pa. (Round 5).

Applications for Round 4 slots were due on July 25, 2013, and applications for Round 5 slots were due on Aug. 29, 2013. A total of 8 hospitals in New York and New Jersey received slots through Round 4 of the program, and 10 hospitals in Alabama, New Jersey, and Pennsylvania received slots through Round 5.

The closed hospital residency slot redistribution program was required by Sec. 5506 of 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] and in the Fiscal Year (FY) 2013 Inpatient Prospective Payment Systems (IPPS) Final Rule [see Washington Highlights, Aug. 3, 2012].

Under the program, CMS is 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 preference in distributing these permanent slots to hospitals that:

  • Assumed an entire program from the closed hospital;
  • 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
  • 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.

Through five rounds of awards, 1242.59 DGME slots and 1172.49 IME slots have been awarded through this AAMC-supported program.

Awardees of Round 6 of the Section 5506 slot redistribution program, from closed hospitals Cooper Green Mercy Hospital, in Birmingham, Ala., and Sacred Heart Hospital, in Chicago, for which applications were due Oct. 31, 2013, have not yet been released.   


Len Marquez
Senior Director, Government Relations
Telephone: 202-862-6281


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