Affordable Care Act - Teaching Health Center Graduate Medical Education Payments Program


Expansion of primary care and dental residency training programs in community based settings.

General information about this opportunity
Last Known Status
Program Number
Federal Agency/Office
Agency: Department of Health and Human Services
Office: Health Resources and Services Administration
Type(s) of Assistance Offered
Formula Grants
Program Accomplishments
Not Applicable.
Section 340H of the Public Health Service Act, as added by Section 5508 of the Patient Protection and Affordable Care Act of 2010 (Pub. L. 111-148); Medicare Access and CHIP Reauthorization Act of 2015 (Public Law 114-10).
Who is eligible to apply/benefit from this assistance?
Applicant Eligibility
Eligible entities include community-based ambulatory patient care centers that operate a primary care residency program. Specific examples of eligible entities include, but are not limited to:
• Federally qualified health centers, as defined in section 1905(l)(2)(B) of the Social Security Act
• Community mental health centers, as defined in section 1861(ff)(3)(B) of the Social Security Act
• Rural health clinics, as defined in section 1861(aa) of the Social Security Act
• Health centers operated by the Indian Health service, an Indian tribe, or tribal organization, or an urban Indian organization, as defined in section 4 of the Indian Health Care Improvement Act
• An entity receiving funds under Title X of the Public Health Service Act.

In addition, the eligible entity must be listed as the institutional sponsor by the relevant accrediting body, including the Accreditation Council for Graduate Medical Education (ACGME), American Osteopathic Association (AOA), or the Council on Dental Accreditation (CODA)

Federally Recognized Indian Tribal Government and Native American Organizations may apply if they are otherwise eligible.
Beneficiary Eligibility
The program supports high-quality primary care residency training in community based settings.
Applicants should review the individual HRSA funding opportunity announcement issued under this CFDA program for any required proof or certifications which must be submitted with an application package. 2 CFR 200, Subpart E - Cost Principles applies to this program.
What is the process for applying and being award this assistance?
Pre-Application Procedure
Preapplication coordination is not applicable. Environmental impact information is not required for this program. This program is excluded from coverage under E.O. 12372.
Application Procedure
2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards applies to this program. HRSA requires all applicants to apply electronically through

Applications will be reviewed for eligibility including accreditation status, program approval, qualifications of the Project Director, completeness, accuracy and compliance with the requirements outlined in the funding opportunity announcement. Based on this review, the HRSA program official with delegated authority is responsible for final selection and formula-based funding decisions. Notification is made in writing (electronic) a Notice of Award.
Award Procedure
Notification of award is made in writing (electronic) through a Notice of Award.
Contact the headquarters or regional office, as appropriate, for application deadlines.
Approval/Disapproval Decision Time
From 120 to 180 days.
Not Applicable.
Not Applicable.
How are proposals selected?
Payments are for direct and indirect expenses for expansion of existing or establishment of new residency training programs in qualified teaching health centers. This is a formula-based grant payment program, with funds awarded to all eligible entities. Application review is conducted at HRSA and an independent assessment of residents’ count is conducted by fiscal intermediaries.
How may assistance be used?
Payments are for direct and indirect expenses for expansion of existing or establishment of new residency training programs in qualified teaching health centers. Eligible residencies include family medicine, internal medicine, pediatrics, med-peds, ob/gyn, psychiatry, general and pediatric dentistry, geriatrics. THCGME (Teaching Health Center Graduate Medical Education Program) payments cannot duplicate payments from other GME funding such as Children’s Hospital GME and payments from the Centers for Medicare and Medicaid Services.
What are the requirements after being awarded this opportunity?
The awardee must submit an annual report and complete reconciliation at the end of each Federal Fiscal year. Cash reports are not applicable. The recipient will be required to submit semi-annual performance and annual progress reports. A Federal Financial Report (SF-425) is required according to the schedule in HRSA’s Application Guide. A final report is due within 90 days after the project period ends. If applicable, the recipient must submit a Tangible Personal Property Report (SF-428) and any related forms within 90 days after the project period ends. New awards (“Type 1”) issued under this funding opportunity announcement are subject to the reporting requirements of the Federal Funding Accountability and Transparency Act (FFATA) of 2006 (Pub. L. 109–282), as amended by section 6202 of Public Law 110–252, and implemented by 2 CFR Part 170. Grant and cooperative agreement recipients must report information for each first-tier subaward of $25,000 or more in federal funds and executive total compensation for the recipient’s and subrecipient’s five most highly compensated executives as outlined in Appendix A to 2 CFR Part 170 (The FFATA details are available online at Competing continuation recipients, etc. may be subject to this requirement and will be so notified in the Notice of Award. Expenditure reports are not applicable. Performance monitoring is not applicable.
This program is excluded from coverage under 2 CFR 200, Subpart F - Audit Requirements. 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 THC during or after the award of funds is subject to review in an audit. The THCGME statute provides for a reconciliation process at the end of each fiscal year, through which overpayments may be recouped and underpayments may be adjusted. (See section 340H (f) of the Public Health Service Act.) The reconciliation process is based on the number of residents reported by the THC for the Federal Fiscal Year to determine the final amount payable to the THC for the Federal Fiscal Year.
Grantees are required to maintain grant accounting records three years after the date they submit the final FFR. If any litigation, claim, negotiation, audit or other action involving the award has been started before the expiration of the three year period, the records shall be retained until completion of the action and resolution of all issues which arise from it, or until the end of the regular three year period, whichever is later.
Other Assistance Considerations
Formula and Matching Requirements
Statutory Formula: Until the Secretary approves the THCGME payment formula an interim payment will be paid to eligible entities.
This program has no matching requirements.
This program does not have MOE requirements.
Length and Time Phasing of Assistance
Awards are based on an annual assessment. See the following for information on how assistance is awarded/released: Grantees draw down funds, as necessary, from the Payment Management System (PMS). PMS is the centralized web based payment system for HHS awards.
Who do I contact about this opportunity?
Regional or Local Office
See Regional Agency Offices.
Headquarters Office
Juliette Jenkins, 5600 Fishers Lane, Room 12C-06, , Rockville , Maryland 20857 Email: Phone: 301-443-6190
Website Address
Financial Information
Account Identification
(Formula Grants) FY 14 $57,412,500; FY 15 est $117,943,815; and FY 16 est $54,000,000
Range and Average of Financial Assistance
Graduate Medical Expense payments for a specific use.
Until the Secretary approves the THCGME payment formula an interim payment of up to $150,000 per resident full time equivalent (FTE) per year will be paid to eligible entities for: (1) Direct expenses (DME) associated with sponsoring an approved graduate medical residency training program; and (2) Indirect expenses (IME) associated with the additional costs related to teaching residents.
Regulations, Guidelines and Literature
All administrative and audit requirements and the cost principles that govern Federal monies associated with this activity will be subject to the Uniform Guidance 2 CFR 200 as codified by HHS at 45 CFR 75.

HRSA awards are also subject to the requirements of the HHS Grants Policy Statement (HHS GPS) that are applicable based on recipient type and purpose of award. The HHS GPS is available at
Examples of Funded Projects
Not Applicable.


Federal Grants Resources