On Friday, November 1, 2019, CMS announced the opening of the application process for teaching hospitals to apply for GME slots from two closed hospitals: Hahnemann University Hospital in Philadelphia, PA (CCN 39-0290), and Ohio Valley Hospital in Wheeling, WV (CCN 51-0039). This announcement in the CY 2020 OPPS final rule officially gave notice of Rounds 16 and 17 of the Affordable Care Act’s section 5506 closed hospital slot redistribution program.

In Round 16, CMS plans to redistribute Hahnemann University Hospital’s DGME and IME FTE caps. An appeal related to the disposition of Hahnemann’s Medicare provider agreement is still pending in the US District Court for the District of Delaware, and the State of Pennsylvania has revoked Hahnemann hospital’s license.  The Delaware District Court issued a stay pending appeal on September 16, 2019. While briefs on the matter were filed in late October, the court has not yet rendered a decision.

In Round 17, CMS will redistribute Ohio Valley Medical Center’s FTE caps.

Below are details on the closures and the slots to be redistributed through both rounds:

Applications for Hahnemann and Ohio Valley Hospital’s FTE resident caps must be received by the CMS Central Office by January 30, 2020 (90 days from November 1, 2019).

Section 5506 of the ACA requires CMS to implement the closed hospital residency slot redistribution program. Under the program, CMS is required to take all of the DGME and IME residency slots from hospitals that closed on or after March 23, 2008, and to permanently redistribute them according to certain criteria. Prior to the ACA, hospitals that took on displaced residents from closed hospitals could only receive cap slots temporarily until the displaced residents completed their training, but there was no provision for the permanent redistribution of closed hospital slots.

The ACA specifies that hospitals in the same geographic region as the closed hospital are to receive priority for the closed hospital’s slots. Among other criteria, CMS also gave preference in distributing these permanent slots to hospitals that:

• Assumed an entire program from the closed hospital;
• Received slots from the closed hospital under a GME affiliation agreement and would use the slots to continue to train at least the number of residents the hospital had trained under the affiliation agreement; and
• Took in residents displaced by the hospital closure and would continue to train residents in the same programs as the displaced residents, even after the displaced residents completed their training.

The GME@Dentons team listed above are happy to answer any questions you may have about this announcement, the application process for closed hospital slots, or broader inquiries about Medicare funding of graduate medical education.