How are teaching hospitals typically reimbursed?
How do hospitals get Medicare reimbursement?
How Does Medicare pay IME?
What is a GME payment?
Do children's hospitals receive Medicare?
Because children’s hospitals treat few Medicare patients, they receive very little funding from the Medicare program for their GME expenses. However, these hospitals are eligible to receive payments through the Children’s Hospitals GME (CHGME) Payment Program, which is funded by Congress through general federal appropriations dollars and administered by the Health Resources and Services Administration. This program generally follows the Medicare rules for counting residents and setting caps on the number of funded positions. More information on the CHGME program is available
Does a hospital count bench research?
For DGME payments, a hospital may count the time a resident spends performing research, including bench research, as long as the research takes place in the hospital and is part of an approved training program. For IME payments, a hospital may only count the time a resident spends performing clinical research that is associated with the treatment or diagnosis of a particular patient.
What is DGME in Medicare?
The Medicare program makes payments to teaching hospitals for a portion of these added costs through direct graduate medical education (DGME) payments. The DGME payment compensates teaching hospitals for "Medicare's share" of the costs directly related to the training of residents. DGME is paid on a per-resident amount as a separate pass-through ...
What is PRA in teaching hospitals?
A new PRA is equal to the lower of the hospital’s actual cost per resident incurred in the base period, or the weighted mean average PRA of all of the other existing teaching hospitals located in the same core-based statistical area (CBSA) as the new teaching hospital.
What is an accreditation letter?
Formal accreditation letter or proof of accreditation of the applicable program (s) by the relevant accrediting body. Number of accredited positions being trained in the program for the relevant cost reporting year for which interim rates are being established.
Does Medicare pay for inpatient PPS?
Medicare pays for the indirect costs involved in the training of residents. For each Medicare case paid under the inpatient PPS, a teaching hospital receives an additional payment, calculated as a percentage add-on to the basic price per case.