Children's Hospitals Graduate Medical Education Payment Program

 

The purpose of the CHGME Payment Program is to compensate for the disparity in the level of Federal Graduate Medical Education (GME) funding for freestanding childrens teaching hospitals versus other types of teaching hospitals. Hospitals typically receive support for graduate medical education (GME) through Medicare, and those payments are provided to hospitals based on their Medicare patient volume. Freestanding childrens hospitals receive little to no Graduate Medical Education (GME) funding from Medicare because childrens hospitals have a low Medicare caseload. The CHGME Payment Program supports freestanding childrens teaching hospitals that: 1) Educate and train future pediatricians, pediatric sub-specialists, and other non-pediatric residents, including residents in dentistry; 2) Provide care for vulnerable and underserved children; and 3) Conduct innovative and valuable pediatric research. The CHGME Support Reauthorization Act of 2013 contained a provision to establish a quality bonus system (QBS). The goal of the QBS is to recognize and incentivize those CHGME Payment Program awardees with high quality training to meet the pediatric workforce needs of the nation.

Active 93.255 Health Resources and Services Administration, Department of Health and Human Services C - Direct Payments For Specified Use Fiscal Year 2016 In Academic Year 2015-2016, the CHGME program supported the training of 5,017 pediatric residents that included general pediatrics residents, as well as residents from five types of combined pediatrics programs (e.g., internal medicine/ pediatrics). Additionally, 2,713 pediatric medical subspecialists, 285 pediatric surgical subspecialists, and 365 pediatric dentistry residents were trained. The CHGME also supported training of 3,120 non-pediatric residents and fellows in the care of children. CHGME-funded medical residents and fellows provided a total of 2,075,887 patient encounters in primary care settings and a total of 4,799,074 patient contact hours in medically underserved communities.
Fiscal Year 2017 : In Academic Year (AY) 2016-2017, CHGME supported the training of 4,975 Pediatric residents that included General Pediatrics residents, as well as residents from seven types of combined pediatrics programs (e.g., Internal Medicine/Pediatrics). Additionally, CHGME supported 2,962 Pediatric Medical Subspecialists, 234 Child and Adolescent Psychiatry fellows, 424 CHGME-funded Advanced Dentistry residents including 300 Pediatric Dentists, and 3,571 Adult Medical and Surgical Specialists. Pediatric residents supported by the CHGME program accounted for 47 percent of all Pediatric residents trained in the United States during AY 2016-2017. Additionally, Pediatric Medical and Surgical Specialists and Subspecialists supported by CHGME accounted for 58 percent of pediatric specialists trained in the United States. CHGME-funded medical residents and fellows provided care during more than 1.7 million patient encounters in primary care settings. CHGME-funded medical residents and fellows provided over 5.2 million hours of patient care in medically underserved communities.
Fiscal Year 2018 No Current Data Available
Fiscal Year 2019 No Current Data Available
Fiscal Year 2020 In FY 2019-2020, CHGME supported the training of 5,433 Pediatric residents that included General Pediatrics residents, as well as residents from seven types of combined pediatrics programs (e.g., Internal Medicine/Pediatrics). Additionally, 3,055 Pediatric Medical Subspecialists, including 199 Child and Adolescent Psychiatry fellows, received training.
Fiscal Year 2021 In Academic Year 2020-2021 CHGME funded over 13,000 physician and dental residents and fellows. The program supported the training of 5,628 Pediatric residents and 2,904 Pediatric medical subspecialty fellows, including training 198 Child and Adolescent Psychiatry fellows. Moreover, CHGME funding was responsible for training 4,572 Adult Medical and Surgical Specialty Residents who rotate through children’s hospitals for their pediatrics training. There were also 430 CHGME-funded Advanced General Dentistry residents, including 340 Pediatric Dentistry and 21 Pediatric Orthodontist residents. CHGME-funded hospitals reported having 1,538 patient safety initiatives and programs, with their medical residents and fellows providing over 5.5 million hours of patient care in medically underserved communities.
Fiscal Year 2022 In Academic Year 2021-2022 CHGME funded over 15,515 physician and dental residents and fellows.  The program supported the training of 6,124 Pediatric residents and 3,201 Pediatric medical subspecialty fellows, including training 206 Child and Adolescent Psychiatry fellows. Moreover, CHGME funding was responsible for training 5,357 Adult Medical and Surgical Specialty Residents who rotate through children’s hospitals for their pediatrics training. There were also 516 CHGME-funded Advanced General Dentistry residents, including 415 Pediatric Dentistry and 23 Pediatric Orthodontist residents. CHGME-funded hospitals reported having 1,639 patient safety initiatives and programs, with their medical residents and fellows providing over 5.1 million hours of patient care in medically underserved communities. 42 U.S.C. § 256e (§ 340E of the Public Health Service Act), as amended by the Dr. Benjy Frances Brooks Children's Hospital GME Support Reauthorization Act of 2018 (P.L. 115-241) A children's hospital is eligible to apply for CHGME Payment Program funding if it participates in an approved GME program; has a Medicare Provider Agreement; is excluded from the Medicare Inpatient Prospective Payment System (IPPS); and operates as a freestanding children's teaching hospital. A freestanding children's teaching hospital does not operate under a Medicare hospital provider number assigned to a larger health care entity that receives Medicare GME payments. A hospital remains eligible for payments as long as it trains residents as a freestanding children's hospital during the federal fiscal year that HRSA makes CHGME program payments. Any public or private nonprofit and profit freestanding children's teaching hospital with an accredited residency training program which meets all eligibility requirements may apply. This program is excluded from coverage under 2 CFR 200, Subpart E - Cost Principles. Applicants should review the individual HRSA Notice of Funding Opportunity (NOFO) issued under this assistance listing for any required proof or certifications which must be submitted with an application package. Preapplication coordination is not applicable. 2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards applies to this program. This program is excluded from coverage under 2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. HRSA requires all applicants to apply electronically through Grants.gov. All eligible qualified applications are reviewed by HRSA Staff. Notification is made in writing (electronic) by a Notice of Award (NOA). Section 340E(a) requires the Secretary of DHHS to make payments for direct and indirect expenses associated with operating approved graduate medical residency training programs for each fiscal year. The two statutory formulas (direct medical education and indirect medical education) outline payments to eligible children's teaching hospitals. Contact the headquarters or regional location, as appropriate for application deadlines Approximately 120 to 180 days after receipt of applications. Other. Hospitals can appeal the determination of FTE resident counts by CHGME fiscal intermediaries to the Provider Reimbursement Review Board (PRRB) under section 1878 of the Social Security Act. Not applicable. Freestanding children's hospitals that meet requirements are deemed eligible to received funding under the CHGME Payment Program. Two type of categories of children's hospitals are eligible for CHGME funding and are either "Currently Eligible Hospitals" or "Newly Qualified Hospitals." Currently Eligible Hospitals are freestanding children's hospitals that meet the original eligibility requirements established prior to the Children's Hospital GME Support Reauthorization Act of 2013. Newly Qualified Hospitals are freestanding children's hospitals that meet the eligibility requirements in the Children's Hospital GME Support Reauthorization Act of 2013. The CHGME Support Reauthorization Act of 2013 contained a provision to establish a quality bonus system (QBS) for CHGME hospitals using any remaining funds after payments to newly qualified hospitals. Funds are restricted to eligible children's hospitals for direct expenses and the other indirect expenses associated with operating approved graduate medical residency programs. Not applicable. This program is excluded from coverage under 2 CFR 200, Subpart F - Audit Requirements. DHHS, or any other authorized federal agency, may conduct an audit to determine whether the applicant has complied with all governing laws and regulations in its application for funding. All information submitted to DHHS by an applicant or participating hospital during or after the award of funds is subject to review in an audit. Eligible hospitals are subjected to the terms of the Full-Time Equivalent Assessment Process Guidance and Assessments which is available electronically via CHGME Payment Program web site noted in Application Procedure above. Recipients are required to maintain grant accounting records for 3 years after the date they submit the Federal Financial Report (FFR). If any litigation, claim, negotiation, audit, or other action involving the award has been started before the expiration of the 3 year period, the records shall be retained until completion of the action and resolution of all issues which arise from it, or until the end of the regular 3 year period, whichever is later. Statutory formula is not applicable to this assistance listing.

Matching requirements are not applicable to this assistance listing.

MOE requirements are not applicable to this assistance listing. In accordance with the Healthcare Research and Quality Act, 1999, Public Law 106-129, the Secretary of DHHS shall determine the number of resident FTE counts before the beginning of each fiscal year that payments are made for a hospital. The amounts of the payments for direct and indirect medical education are made to each hospital in 12 equal interim installments during the Federal fiscal year. Both interim payments (prior to audits) and final payments are computed using a zero sum gain payment model. The calculations of both direct and indirect graduate medical education payments are formula based. Once payments are determined, recipients draw down funds, as necessary, from the Payment Management System (PMS), the centralized web based payment system for HHS awards. None/Not specified. Lisa Flach-Fulcher , Division of Medicine and Dentistry, Bureau of Health Workforce
5600 Fishers Lane, Room 15N190A
Rockville, MD 20857 US
aflach-fulcher@hrsa.gov
Phone: 301-443-0365 https://bhw.hrsa.gov/grants/medicine/chgme 75-0350-0-1-550 (Direct Payments for Specified Use) FY 22$356,635,642.00; FY 23 est $365,469,351.00; FY 24 est $365,436,385.00; FY 21$331,827,565.00; FY 20$323,713,555.00; FY 19$305,860,672.00; FY 18$300,000,000.00; FY 17$282,823,526.00; FY 16$279,033,446.00; - FY 22 Range: $30,274 - $26,094,531; Average $6,020,769 in combined DME and IME payments and eligible awardees QBS payments. FY 23 Range est: $33,537 - $24,093,733; Average $6,139,588 in combined DME and IME payments and eligible awardees QBS payments. FY 24 Range est: $33,537 - $24,093,733; Average $6,139,588 in combined DME and IME payments and eligible awardees QBS payments. Healthcare Research and Quality Act, 1999 (Public Law 106-129), Section 340E of the Public Health Service Act; The Children's Health Act, 2000 (Public Law 106-310, Title XX); Public Law 108-490; Public Law 109-307; Public Law 113-98; Public Law 115-241. Social Security Act, Section 1886, 42 CFR 412.105; 42 CFR 413.86; FRN Vol. 65, No. 118 published on June 19, 2000; FRN Vol. 66, No. 41 published on March 1, 2001; and FRN Vol. 66, No. 140 published on July 20, 2001, and FRN Vol. 68, No. 204, published on October 22, 2003. HRSA awards are also subject to the requirements of the HHS Grants Policy Statement (HHS GPS) that are applicable based on recipient type and purpose of award. The HHS GPS is available at http://www.hrsa.gov/grants/hhsgrantspolicy.pdf. Not applicable.