What this means precisely at this point is unknown. Also, the Secretary is to give special consideration to facilities that meet the needs of patients in under served rural areas. One of the most heated controversies concerning graduate medical education concerned whether Medicare HMO's should have removed from their capitated payments the portions for graduate medical education and disproportionate share. Congress decided to mandate, over five years, removal of the portion for graduate medical education, but not disproportionate share. The new program described below is to encourage hospitals to downsize voluntarily their residency programs and is modeled after the New York demonstration project approved by HCFA earlier this year.
Eligible applicants are hospitals or consortia.
Applications are required and must be submitted no later than November 1, 1999. The law spells out certain residency reduction requirements. First, the law stipulates a beginning condition. First, the government will calculate the amount of DGME and IME the applicant would have received had it not proposed to downsize along the conditions outlined above. The amount the government would pay for the reduced residency levels is then subtracted from the amount calculated for the program with no reductions.