Medicaid seeks to cut contribution to GME funding

A change would hurt teaching programs, medical education leaders say.

By Myrle Croasdale, AMNews staff. July 9, 2007.

Teaching hospitals' training budgets could be cut between 15% to 30% if a proposed Centers for Medicare & Medicaid Services rule change goes into effect.

The Dept. of Health & Human Services wants to end federal matching of state Medicaid graduate medical education reimbursements.

The government estimates that its revised policy would cost teaching hospitals $1.78 billion spread out over five years, but GME leaders say it actually could be that much per year.

"This would cripple the financial ability of our institutions to train tomorrow's doctors," said Kenneth E. Raske, president and CEO of the Greater New York Hospital Assn., whose hospitals train 16% of medical residents in the United States.

Teaching hospitals escaped the cut this year. Congress passed a one-year moratorium on the cut as part of a military spending bill approved May 25.

"We're going to fight very hard to prevent the implementation of this rule," said Lynne Davis Boyle, assistant vice president, Office of Governmental Relations, for the Assn. of American Medical Colleges.

The American Medical Association also opposes the proposed cut.

HHS argues that paying for medical education is not justified under the Medicaid statute. While CMS previously allowed states to include resident education costs as a component of patient care costs, the Medicaid statute does not expressly authorize this practice, HHS said. Education is not part of the cost of treating a patient, it argues, and the proposed rule change would eliminate this practice.