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  • Washington Highlights

    Congress Passes CHGME Reauthorization

    Matthew Shick, Sr. Director, Gov't Relations & Regulatory Affairs
    Andrew Amari, Hospital Policy and Regulatory Specialist

    The Senate Sept. 4 passed by unanimous consent the Children's Hospital Graduate Medical Education (CHGME) Support Reauthorization Act of 2018 (H.R. 5385), clearing the bill for the President’s signature. The bill authorizes the CHGME program for five years (through 2023) at $325 million per year, a $25 million (7.7%) increase over the previous authorization. Both the House and Senate fiscal year (FY) 2019 Labor-HHS appropriations bills include $325 million for CHGME, a $10 million (3%) increase over FY 2018 (see related story).

    The AAMC sent a July 11 letter in support of the measure, noting that “the CHGME program provides necessary support for the training programs at children’s hospitals across the country that produce general pediatricians and pediatric specialists” [see Washington Highlights, July 13].

    Meanwhile, the Congressional Research Service (CRS) released an August 2018 report on CHGME that covers the program’s origins, authorizations, payments, distributions, and training. The report notes that the program trained over 7,100 residents in academic year 2016-17 across 58 free-standing children’s hospitals in 29 states. CRS also raised several policy issues that Congress might consider:

    • Address whether the program is training an adequate number of residents to meet the current and future workforce needs, and whether the support per resident is appropriate;

    • Evaluate the program’s current payments to new hospitals, which are limited to a subset of the CHGME budget, and determine whether the limitation is appropriate and, if so, whether the allocated funds for those new hospitals are sufficient; and
    • Consider the state of data on the residents trained in the CHGME program, and whether to create additional funds for meeting quality targets and/or create punishments for those that fail to meet those targets.

    The AAMC previously submitted comments to the Health Resources and Services Administration regarding the establishment of standards for the CHGME Payment Program’s Quality Bonus System, cautioning that the purpose of CHGME grants is to pay for GME and the quality bonus payment must be tied to the training program, not to other hospital activities [see Washington Highlights, June 29].