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CHGME Reauthorization Awaits President’s Signature

April 4, 2014—The House April 1 approved by voice vote the Children’s Hospitals GME Support Reauthorization Act of 2013 (S. 1557), reauthorizing funding for the Children’s Hospitals Graduate Medical Education (CHGME) program through fiscal year (FY) 2018. The Senate passed the measure by unanimous consent in November [see Washington Highlights, Nov. 15]. The bill now awaits President Obama’s signature.

The bill authorizes $300 million for each of fiscal years 2014 through 2018; however, final funding levels for the CHGME program are determined in and provided through annual appropriations bills.

Additionally, S. 1557 authorizes the Secretary of Health and Human Services to direct a portion of CHGME payments to certain hospitals with approved residency programs that: are exempt from Medicare’s prospective payment system (“PPS-exempt” hospitals); treat inpatients who are “predominantly individuals under 18 years of age”; and are otherwise not qualified to receive GME payments under Medicare. Total awards under this section could equal up to 25 percent of any CHGME appropriations in excess of $245 million, but could not exceed $7 million. The secretary may establish residency caps for this group of teaching hospitals.

Under the bill, the secretary also may establish a “quality bonus system” for distributing to participating hospitals on an annual basis any unspent CHGME funds. To receive quality bonus payments, CHGME-eligible hospitals would have to meet certain standards, such as training in community-based settings, delivering patient-centered care, or practicing in integrated health systems. The secretary would work with “relevant stakeholders” (e.g., accrediting bodies, certifying boards, providers, patient/consumer groups) to develop these standards.


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

Christiane Mitchell
Senior Director Health Care Affairs
Telephone: 202-828-0461


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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