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| 93.255 CHILDREN'S HOSPITALS GRADUATE MEDICAL EDUCATION PAYMENT |
| (CHGME Payment Program) |
| 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; Public Law 108-90; Social Security Act. |
| 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 (BHP). |
| 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. |
| 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 meets all eligibility requirements may apply. |
| Credentials/Documentation |
| Applicants should review the individual HRSA Guidance documents issued under this CFDA program for any required proof or certifications which must be submitted prior to or simultaneous with submission of an application package. |
| Preapplication Coordination |
| This program is excluded for coverage under E.O. 12372. |
| Application Procedure |
| Grant applications and required forms for this program can be obtained from Grants.gov. Please visit the Grants.gov Web site at www.grants.gov to both find and apply for all Federal grant opportunities. All qualified applications will be forwarded to an objective review committee which will make funding recommendations to the Associate Administrator for the Bureau of Health Professions. The Associate Administrator has the authority to make final selections for awards. |
| 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 |
| None. |
| Appeals |
| Hospitals can appeal the determination of FTE resident counts by CHGME fiscal intermediaries to the Provider Reimbursement Review Board (PRRB) under section 1878 of the Social Security Act. |
| Renewals |
| Eligible children's hospitals must complete a CHGME Payment Program application for inclusion in the program for each fiscal year that they are applying for funds. |
| 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. and FRN Vol 68, No. 208, published October 22, 2003. The formula was updated to incorporate section 422 of the Medicare Modernization Act (MMA) and updates to variables used in the formulas made by CMS through rules and regulations. 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 12 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. |
| Reports |
| Public Law 109-307 requires children's hospitals receiving CHGME funds to submit an annual report that focuses on their GME training program. The Department has to submit a report to Congress by 2011. |
| Audits |
| In accordance with the provisions of OMB Circular No. A-133 (Revised, June 27, 2003), "Audits of States, Local Governments, and Nonprofit Organizations," nonfederal entities that expend financial assistance of $500,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133. |
| Records |
| All records must be maintained until expiration of 3 years from the date of submission of the final expenditure report. If questions remain following the 3-uear period, such as those raised as a result of an audit or an on-going enforcement action, recipients must retain records until the matter is completely resolved. |
| Account Identification |
| 75-0350-0-1-550. |
| Obligations |
| FY 07 $297,000,000; FY 08 $301,000,000; and FY 09 est. $301,000,000. |
| Range and Average of Financial Assistance |
| $5,982 to $20,273,990; $4,737,879 in combined DME and IME payments. |
| PROGRAM ACCOMPLISHMENTS |
| The CHGMEPP made awards to 60 eligible children's teaching hospitals in FY 07. It is estimated that awards will be made to 57 eligible teaching hospitals in FY 08 and FY 09. |
| REGULATIONS, GUIDELINES, AND LITERATURE |
| This program is subject to the provisions of 45 CFR Part 92 for State, local and tribal governments and 45 CFR Part 74 for institutions of higher education, hospitals, other nonprofit organizations and commercial organizations, as applicable. |
| Regional or Local Office |
| Marilyn Biviano Ph.D, Director, 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) 443-6190. |
| Headquarters Office |
| Grants Management Office: Rick Goodman, Director, Division of Grants Management Operations, Health Resources and Services Administration, Department of Health and Human Services, 5600 Fishers Lane, Room 11A-16. Health Services Branch, Telephone: (301) 443-2385; Research and Training Branch, Telephone:(301) 443-3099; Government and Special Focus Branch, Telephone: (301) 443-3288. |
| Web Site Address |
| www.hrsa.gov; http://www.bhpr.hrsa.gov/childrenshospitalgme |
| RELATED PROGRAMS |
| None. |
| 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. |
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General Services Administration Office of Chief Acquisition Officer Regulatory and Federal Assistance Division (VIR) |
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