Children's Hospitals Graduate Medical Education Payment (93.255)
Program
93.255 Children's Hospitals Graduate Medical Education Payment
Federal Agency
HEALTH RESOURCES AND SERVICES ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES
Authorization
Public Health Service Act, Title III Part D, Section 340E, 42 U.S.C. 256E, as amended; The Children's Health Act, 2000, Public Law 106-310, Healthcare Research and Quality Act, 1999, Public Law 106-129; Social Security Act.
Program Number
93.255
Last Known Status
Active
Objectives
The Children's Hospitals Graduate Medical Education Payment Program (CHGMEPP) provides funds to children's teaching hospitals to support the training of pediatric and other residents in graduate medical education (GME) programs. Since Federal financial support of graduate medical education is extensively supported by the Medicare system, the CHGME program compensates for the disparity in the level of Federal funding for pediatric teaching hospitals versus other types of teaching hospitals. The Secretary of DHHS has delegated the authority for the administration of the CHGME payment program to Health Resources and Services Administration (HRSA), which redelegated it to the Bureau of Health Professions (BHPr).
Types of Assistance
Direct Payments for Specified Use.
Uses and Use Restrictions
Funds are restricted to eligible children's hospitals for direct expenses and the other indirect expenses associated with operating approved graduate medical residency programs.
Eligibility Requirements
Applicant Eligibility
Applicants (children's teaching hospitals) must meet the following eligibility requirements in accordance with the Federal Register Notice, Vol. 66, No. 41 published on March 1, 2001: 1) Participate in an approved graduate medical education program; 2) have a Medicare provider agreement; 3) be excluded from the Medicare Inpatient Prospective Payment System (PPS) under Section 1886(d)(1)(B)(iii), of the Social Security Act and its accompanying regulations; and 4) be a "freestanding" children's hospital.
Beneficiary Eligibility
Any public or private nonprofit and profit children's teaching hospital with an accredited residency training program which meeting all eligibility requirements may apply.
Credentials/Documentation
Payments will be determined in accordance with the Department of Health and Human Services (DHHS) legislation - Public Health Service Act, Title III Part D, Section 340E, 42 U.S.C. 256E, as amended; Graduate Medical Education Programs in Children's Hospitals, Title 20; Federal Register Notice (FRN) Vol. 65, No. 118, published on June 19, 2000; FRN Vol. 66, No. 41, published on March 1, 2001; FRN Vol. 66, No. 140 published on July 20, 2001; and FRN Vol.67, No. 186, published on September 25, 2002.
Application and Award Process
Preapplication Coordination
Not applicable. This program is excluded from coverage under E.O. 12372.
Application Procedure
Applications are made by submission of application face page (HRSA 99), determination of weighted and unweighted resident FTE count form (HRSA 99-1), indirect medical education data related to the teaching of residents form (HRSA 99-2), assurance/certification attestation form (HRSA 99-3), and the performance data (GPRA) tables (HRSA 99-4). For children's teaching hospitals that file full Medicare Cost Reports, adjudication is conducted by comparing the hospital's application to the Medicare Fiscal Intermediary reports. The aforementioned documents are available electronically via the CHGMEPP web site at http://www.bhpr.hrsa.gov/childrenshospitalgme/.
Award Procedure
Notification of award is made in writing by a notice of award letter issued from the headquarters office.
Deadlines
Contact the Headquarters Office for application deadlines. The CHGME web site will also publish the information ahead of time.
Range of Approval/Disapproval Time
Appeals
The appeals process will be addressed as the rule-making process evolves.
Renewals
Eligible children's hospitals must complete a CHGMEPP application for inclusion in the program for each fiscal year that they are applying for funds.
Assistance Considerations
Formula and Matching Requirements
Section 340E(a) requires the Secretary of DHHS to make payments for direct and indirect expenses associated with operating approved graduate medical residency training programs for each fiscal year. The two statutory formulas (direct medical education and indirect medical education) payments to eligible children's teaching hospitals are made as outlined in Federal Register Notice (FRN) Vol. 65, No. 118 published on June 19, 2000; FRN Vol. 66, No. 41 published on March 1, 2001; and FRN Vol. 66, No. 140 published on July 20, 2001 and FRN Vol.67,No. 186, published on September 25, 2002. This program has no statutory matching requirements.
Length and Time Phasing of Assistance
In accordance with the Healthcare Research and Quality Act, 1999, Public Law 106-129, the Secretary of DHHS shall determine before the beginning of each fiscal year that payments are made for a hospital. The amounts of the payments for direct and indirect medical education are made to each hospital in 26 equal interim installments during the period. The Children's Health Act, Public Law 106-310, amends the length of the CHGME Payment Program through fiscal year 2005. Payments are made by an Electronic Transfer System.
Post Assistance Requirements
Reports
None.
Audits
DHHS, or any other authorized Federal agency, may conduct an audit to determine whether the applicant has complied with all governing laws and regulations in its application for funding. Any and all information submitted to DHHS by an applicant or participating hospital during or after the award of funds is subject to review in an audit. Eligible hospitals are subjected to the terms of the Full-Time Equivalent Assessment Process Guidance which is available electronically via CHGMEPP web site noted in Application Procedure above.
Records
In accordance with 45 CFR Part 74, Subpart D, financial and programmatic records, supporting documents, statistical records, and all other records of a participating hospital that are required by the terms of the award or may reasonably be considered pertinent to the award, must be retained for 3 years after the end of a fiscal year. Access to these records is also governed by the provisions of 45 CFR Part 74, Subpart D.
Program Accomplishments
The CHGMEPP made awards to 57 eligible children's teaching hospitals in fiscal year 2001, 59 eligible children's teaching hospitals in fiscal year 2002. It is estimated that awards will be made to 61 eligible teaching hospitals in fiscal year 2003.
Financial Information
Account Identification
75-0350-0-1-550.
Obligations
FY 02 $285,000,000; FY 03 est $292,000,000 and FY 04 est $199,000,000.
Range and Average of Financial Assistance
$3,025 to $22,338,984; $4,681,840 in combined DME and IME payments.
Regulations, Guidelines and Literature
Healthcare Research and Quality Act, 1999 (Public Law 106-129), Section 340E of the Public Health Service Act; The Children's Health Act, 2000 (Public Law 106-310, Title XX); Social Security Act, Section 1886, 42 CFR 412.105; 42 CFR 413.86; FRN Vol. 65, No. 118 published on June 19, 2000; FRN Vol. 66, No. 41 published on March 1, 2001; and FRN Vol. 66, No. 140 published on July 20, 2001.
Related Programs
None.
Information Contacts
Regional or Local Office
None.
Headquarters Office
Program Contact: Ayah Johnson, Chief, Graduate Medical Education Branch, Division of Medicine and Dentistry, Bureau of Health Professions, Health Resources and Services Administration, Department of Health and Human Services, 5600 Fishers Lane, Room 9A-05, Rockville, MD 20857. Telephone: (301) 443-1058.
Web Site Address
http://www.bhpr.hrsa.gov/childrenshospitalgme
Examples of Funded Projects
None.
Criteria for Selecting Proposals
Children's teaching hospitals must meet all of the eligibility criteria before being considered for program funds. This is a noncompetitive annual award.
