On March 14, 2016, the US Senate and the US House of Representatives both introduced the Advancing Medical Resident Training in Community Hospitals Act. If passed, this legislation would solve the so-called "resident rotator" problem described in detail in a recent GME @ Dentons article, "Be careful with resident rotators: What you don't know might hurt your hospital's ability to receive Medicare GME payments in the future."

The bill was introduced in the Senate (S 2671) by Senators Bill Nelson (D-FL), Ron Johnson (R-WI), Rob Portman (R-OH), Tammy Baldwin (D-WI) and Sherrod Brown (D-OH). Representatives Reid Ribble (R-WI) and Ron Kind (D-WI) were the lead sponsors of the bill in the House (H.R. 4732). The legislation addresses three problems:

• Accidental establishment of a hospital's resident limit, or "cap": The bill would permit community hospitals whose caps were accidentally established by small numbers of resident rotators to build and receive Medicare funding for new residency programs. Under the legislation, any hospital whose cap was established based on training fewer than 3.0 full-time equivalent (FTE) resident rotators from new residency training programs between October 1, 1997, and the date of enactment, would be permitted to establish new GME caps.
• Accidental establishment of a hospital's per-resident amount (PRA): The bill would permit community hospitals whose PRAs were accidentally established by small numbers of resident rotators to build and receive Medicare funding for new residency training programs. Under the legislation, any hospital whose PRA was established based on training fewer than 3.0 FTE resident rotators between October 1, 1997, and the date of enactment, would be permitted to establish a new PRA.
• Extremely low base year cap: Any hospital whose base year GME cap was set based on the training of less than 1.0 FTE resident prior to October 1, 1997, would be permitted to establish a new PRA.

Moving forward, a hospital's GME caps and its PRA would not be established until the hospital trained more than 1.0 FTE resident in a given fiscal year.