Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 22 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ADMINISTRATION › Article 7 - STANDARDS FOR PAYMENTS › Section R9-22-712.06 - Supplemental Graduate Medical Education Fund Allocation

Current through Register Vol. 30, No. 28, July 12, 2024
A. Gradual Medical Education (GME)
				reimbursement as of July 1, 2020.
1. In
				addition to distributions according to Section
				R9-22-712.05, and subject to the
				availability of funds and approval by CMS, the Administration shall annually
				distribute monies appropriated for the GME programs approved by the
				Administration to hospitals for direct and indirect costs for graduate medical
				education programs which were established or expanded on or after July 1, 2020.
				The Administration shall estimate the distributions using information possessed
				by the Administration as of December 15 of each calendar year. The actual
				distributions will be made using information possessed by the Administration as
				of September first of the year in which the new residency or fellowship
				begins.
2. Eligible Hospitals. A
				hospital is eligible for distributions under this Section if all of the
				following apply:
a. It is a hospital in
				Arizona that is the sponsoring institution of, or a participating institution
				in, one or more of the GME programs in Arizona;
b. It incurs direct costs for the training of
				residents in the GME programs, which costs are or will be reported on the
				hospital's Medicare Cost Report;
c.
				It is not administered by or does not receive its primary funding from an
				agency of the federal government;
d. It has established a new GME program or
				expanded the number of residents or fellows in an existing GME program on or
				after July 1, 2020.
3.
				Eligible positions. For purposes of determining distributions under this
				Section the following resident and fellowship positions qualify to the extent
				that the training takes place in Arizona at an eligible health care facility:
a. Filled resident or fellow positions in
				approved programs which began on or after July 1, 2020;
b. Eligible positions do not include
				residents or fellows that receive payments for services under the Access to
				Professional Services Initiative (APSI) program established in the Contractors'
				prepaid capitation contracts with the Administration.
4. Annual Reporting
a. By December 15 of each year, a GME program
				shall provide all of the following information for GME programs and positions
				which are expected to be eligible for funding under this Section as of the
				upcoming academic year (i.e., July 1 to June 30 of each year):
i. The program name and number assigned by
				the accrediting organization if available;
ii. The original date of accreditation if
				available;
iii. The names of the
				sponsoring institution and all participating institutions expected as of the
				date of reporting;
iv. The number
				of anticipated resident and fellowship positions eligible for funding as of the
				upcoming academic year;
v. The
				number of months or partial months during the upcoming academic year that each
				resident or fellow is expected to work in each hospital or in a non-hospital
				setting under agreement between the non-hospital setting and the reporting
				hospital;
vi. The academic year of
				anticipated resident and fellowship positions;
vii. The length of the program; and
viii. The names and other information
				requested by AHCCCS to ensure the total GME distributions for each eligible
				position are not greater than the costs for each eligible position in the
				Intern and Resident Information System (IRIS) file.
b. By December 15 of each year, a GME program
				located in a county with a population of less than 500,000 persons shall
				provide the estimated one-time and ongoing costs for each program which it
				expects to be eligible for funding.
c. By September 1 of each year, a GME program
				shall provide the actual name of residents and fellows hired in the current
				academic year and other information requested by AHCCCS to ensure that total
				GME distributions for the eligible position are not greater than the costs for
				each eligible position in the IRIS file.