The Centers for Medicare and Medicaid Services released a proposed rule on May 18 that would clarify that costs and payments associated with graduate medical education programs are not expenditures for medical assistance that are federally reimbursable under the Medicaid program.
Under section 1903(a)(1) of the Social Security Act, federal grant funding, or federal financial participation, is available to states for a percentage of amounts “expended … for medical assistance under the state plan.” CMS has previously allowed states to include hospital GME activities as a component of the cost of Medicaid inpatient and outpatient hospital services.
Quoting CMS, “we do not believe that it is consistent with the Medicaid statute to pay for GME activities either as a component of hospital services or separately. GME is not a health service that is included in the authorized coverage package. Nor is GME recognized under the Medicaid statute as a component of the cost of Medicaid inpatient and outpatient hospital services. GME is not a health service (in contrast to the activities of disproportionate share hospitals). Therefore, we are proposing in this issuance to preclude FFP in state payments for GME.”
Comments must be received within 30 days from the date published in the Federal Register (that date is expected to be May 23). Read the proposed rule.
