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CMS Announces Sixth Round Awardees of Redistributed Resident Slots from Closed Hospitals

October 31, 2014The Centers for Medicare and Medicaid Services (CMS) Oct. 31 released a new round 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 27.64 Direct Graduate Medical Education (DGME) slots and 33.65 Indirect Medical Education (IME) slots from two closed hospitals: Cooper Green Mercy Hospital in Birmingham, Ala. and Sacred Heart Hospital in Chicago, Ill.

Applications for Round 6 slots were due on Oct. 31, 2013. A total of five hospitals in two states (Alabama and Illinois) received slots through Round 6 of the program.

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 six rounds of awards, 1,289.9 DGME slots and 1,231.27 IME slots have been awarded through this AAMC-supported program.

Awardees of Round 7 of the Section 5506 slot redistribution program, from closed hospital Long Beach Medical Center in Long Beach, N.Y. for which applications were due Sept. 5, 2014, 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