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Non-Provider/Non-Hospital
Setting (Rotation Sites) | Payment
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Non-Provider/Non-Hospital
Setting
The time a resident spends in a non-provider (or non-hospital)
setting such as a physician’s office or a freestanding community
health center in connection with an approved program may be included
in the resident FTE count if:
1. the resident is engaged in patient care activities; and
2. there is a written agreement between the hospital and the non-hospital
site which states that the hospital will:
a. incur cost of residents training;
b. provide reasonable compensation for supervisory activities; and
c. incur substantially all costs for the training program.
Example:
A pediatric resident in a program sponsored by the children’s hospital
spends two days a week as part of the residency program at a community health
center. There is a written agreement that states that the (children’s)
hospital will pay the resident’s salary and compensate the community health
center for time the center’s physicians spend supervising the resident. Thus,
the resident’s time at the community health center would be counted by the
children’s hospital. The resident’s time would not be counted (by the
children’s hospital) if the community health center paid the resident's salary
and incurred the supervising physician costs.
Additional references:
Social Security Act, Section 1886
42 CFR 413.86 (Centers for Medicaid and Medicare Services, formerly the Health
Care Financing Administration)
CHGME Payment Program, Federal Register Notice dated March 1, 2001 (66 FR 12940)
Applicable to the following application forms:
HRSA-99-1, HRSA-99-2
and HRSA-99-4
Payment
Methodology
CHGME Payment Program funding to individual hospitals is based upon
a hospital’s (1)
1. rolling average of the weighted resident FTE count for direct medical education
(DME) payments; and the
2. rolling average of unweighted resident FTE count for indirect medical education
(IME) payments.
The rolling average is the average of the resident FTE counts reported
by the hospital for the (1)
1. most recently filed Medicare cost report (MCR) [or the most recently completed
Medicare cost reporting period];
2. the previously filed MCR (or the previously completed Medicare cost reporting
period); and
3. the penultimate filed MCR (or the penultimate completed Medicare cost reporting
period).
(1) CHGME Payment Program funding to a children’s hospital that has not
completed three (3) full Medicare cost reporting periods will be based upon
the hospital’s resident FTE count from its “most recently filed” or “most recently
completed” Medicare cost reporting period until three (3) full Medicare cost
reporting periods have been completed.
The rolling average is based upon the number of:
1. allopathic and osteopathic residents following application of the “cap”,
where applicable; and
2. the residents in dentistry and podiatry.
The rolling average resident FTE count includes all residents except those
in the initial years of a program that meet the criteria for an exception to
the averaging rules for new programs. New residents of a new training
program are not included in the averaging, but are added to the final count
for a period equal to the minimum accredited length of the program.
Other payment variables, in addition to the rolling average of weighted and
unweighted resident FTE counts, are used to calculate DME and IME payments. The
complete list of payment variables used to determine DME and IME payments are
located in the June 19, 2000 (65 FR 37985) and July 20, 2001 (66 FR 37980)
Federal Register notices, respectively.
Additional references:
Social Security Act, Section 1886
42 CFR 413.86 (Centers for Medicaid and Medicare Services, formerly the Health
Care Financing Administration)
CHGME Payment Program, Federal Register Notice dated June 19, 2000 (65 FR 37985)
CHGME Payment Program, Federal Register Notice dated March 1, 2001 (66 FR 12940)
CHGME Payment Program, Federal Register Notice dated July 20, 2001 (66 FR 37980)
Applicable to the following application forms:
HRSA-99-1, HRSA-99-2, and HRSA-99-4
Payment
Process Flow Chart |
