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The 2013 Inpatient Prospective Payment System Proposed Rule, issued by the Centers for
Medicare & Medicaid Services (CMS) on May 11, 2012, proposes
some important changes relating to graduate medical education (GME)
reimbursement for teaching hospitals. Comments regarding the
Proposed Rule are due June 25, 2012.
The GME-related changes in the Proposed Rule include:
Increasing the period of time, from three years to five, in
which a new teaching hospital can establish its full-time
equivalent (FTE) cap and changing the calculations of new
hospitals' direct GME and indirect GME (IME) caps when
residents rotate to more than one hospital during the cap-building
period;
Creating additional requirements in order for hospitals that
received additional slots from hospitals that had their caps
reduced to keep those slots;
Changing the ranking criteria for hospitals applying for cap
space from hospitals that closed, as well as the effective dates of
the transferred slots; and
Including labor and delivery beds in the calculation of the
hospital's IME adjustment.
Teaching hospitals should review and closely analyze each of the
proposed changes to determine whether they achieve the best result
for the hospital's Medicare GME reimbursement needs.
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