Teaching hospitals interested in applying for the most recent round of slots through the Affordable Care Act (ACA) section 5506 closed hospital slot redistribution program must submit an application to CMS by Wednesday, October 31, 2018. CMS announced Round 13 of the ACA’s slot redistribution program in the FY 2019 IPPS final rule, published August 17, 2018. Under this round, CMS will redistribute 73.66 IME slots and 72.62 DGME slots from closed hospital Memorial Hospital of Rhode Island. Of the available IME slots, 5.91 FTEs are from a section 422 cap increase, meaning they will be reimbursed at half the normal rate.

Section 5506 of the ACA required 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 specified that hospitals in the same geographic region as the closed hospital would 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 can answer your questions about the most recent round of slots being redistributed, or broader inquiries about Medicare funding of graduate medical education.