GNYHA submitted comments last week to a Senate Finance Committee Working Group that sought feedback on a bipartisan policy “outline” proposing to enhance and modify the Medicare graduate medical education (GME) program.
The proposal would raise the number of residency positions eligible for Medicare direct graduate medical education (DGME) and indirect medical education (IME) support, with a focus on bolstering primary care and psychiatry residency programs, increasing the diversity of the physician workforce, boosting data collection and transparency in the GME program, and expanding access to care for rural and underserved areas.
GNYHA recommended that new legislation include at least 10,000 new Medicare-reimbursable residency slots and suggested a maximum of 25 of these slots per hospital (the Working Group proposed a maximum of 10 per hospital).
GNYHA also recommended that the Working Group provide targeted financial support to rural hospitals seeking to develop and bolster their GME infrastructure, such as the Rural Residency Planning and Development Act of 2024.
In addition, GNYHA urged Congress to permanently extend the telehealth flexibilities in the Consolidated Appropriations Act (CAA), 2023, which are scheduled to expire on December 31, 2024. GNYHA supports extending the flexibilities that allow teaching physicians to use telehealth to train residents.
The Working Group proposed a change to the CAA, 2021 provision that resets the low GME caps of certain hospitals to provide 10 years, rather than five, for hospitals to establish a new per resident amount or residency full-time equivalent (FTE) cap. GNYHA supports this revision and recommended Congress create another category to include hospitals that do not qualify under the current statute. For hospitals that have not trained residents for a certain number of years, GNYHA recommended that those hospitals become immediately eligible for the establishment of new caps and that Congress specify that those hospitals become immediately eligible to have their DGME and/or IME caps reset if they have not trained more than a de minimis number of resident FTEs (e.g., one, three) in the years up until the date of enactment.
GNYHA further suggested that Congress amend the Medicare statute to allow hospitals to receive separate Medicare payments for clinical education programs even if they are not the operator of the educational program. Finally, GNYHA urged Congress to develop and bolster immigration pathways for qualified foreign national health workers to address gaps in the domestic workforce.