GNYHA Continues to Advocate for Increased GME Funding In Face of Opposition

January 27, 2020

GNYHA has long advocated for increasing outdated caps on Medicare-reimbursed physician residency slots. These caps have created a bottleneck for medical school graduates and have contributed to the nation’s worsening physician shortage. GNYHA and our allies have been working throughout the 116th Congress to gain support for proposals to address this issue, such as the Resident Physician Shortage Reduction Act of 2019 (S. 348/H.R. 1763) and the Opioid Workforce Act of 2019. Both bills have made gained strong support in recent months, for which we are extremely grateful.

The Resident Physician Shortage Reduction Act of 2019, which would fund 15,000 new Medicare-reimbursed residency slots over five years, has more than 170 bipartisan cosponsors in the House, and nearly 20 bipartisan cosponsors in the Senate. As the bill approaches 200 cosponsors in the House, it sends a strong message to Congress and the Administration that the physician shortage must be addressed and that GME funding cuts are unpalatable.

Highlighting the importance of our work on this legislation are recent statements by Senate Finance Committee Chairman Chuck Grassley (R-IA). Senate Finance Committee Chairman Chuck Grassley (R-Iowa) sent a letter to Department of Health & Human Services (HHS) Secretary Azar in October requesting information on Federal funding of several graduate medical education (GME) programs. The stated reason for the request was to understand how HHS ensures that GME funding isn’t wasteful and has proper oversight.

Last week, the Finance Committee released the response from Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma. Administrator Verma answered many of Chairman Grassley’s questions and specifically focused on:

  • The Trump Administration’s fiscal year 2020 budget proposal to consolidate funding for Medicare GME, Medicaid GME, and the Children’s Hospital GME Program into a single grant program funded out of the general fund.
  • Explaining that the Federal statute is “prescriptive” and does not give CMS the authority to take physician workforce needs into consideration.
  • Explaining CMS’s use of Medicare Administrative Contractors to process and audit payments for health care items and services submitted by teaching hospitals (including GME payments), and to audit the number of resident full-time employees that hospitals report on their annual cost report by reviewing relevant rotation schedules.
  • Describing how CMS avoids duplicate payments for residents by requiring teaching hospitals to submit Intern and Resident Information System files as part of their cost reports.

In response to Administrator Verma’s letter, Chairman Grassley issued a statement in which he said, “We can’t just keep dumping federal funds into programs that may not be addressing the needs of our rural communities. I plan to explore options that protect taxpayer dollars and target medical resident training to best serve patients.”

GNYHA will meet with Chairman Grassley’s staff to address his concerns and to offer our GME expertise, including the numerous oversight and audit processes already in place, the massive cuts that would occur if the President’s GME proposals were enacted, ways that the GME community is addressing the needs of underserved and rural areas, and the need for the nation to have a stronger physician pipeline and additional GME funding to support it.

Also on the GME front, the Opioid Workforce Act of 2019, which would fund 1,000 new Medicare-reimbursed residency slots in specialties related to substance use disorders such as pain management, addiction medicine, and addiction psychiatry, is gaining significant support. The legislation currently has 58 cosponsors in the House, passed the House Ways & Means Committee with bipartisan support, and has three Republican cosponsors in the Senate.

GNYHA strongly advocates for the inclusion of the Opioid Workforce Act in health care legislation that will likely move ahead of the May 22 deadline when the health care extenders package expires. Between now and then, lawmakers need to hear from their constituents that the Opioid Workforce Act should be a priority. To help with this effort, we created a new grassroots advocacy portal to launch a campaign in support of the bill. By clicking here, you will reach a landing page with background on the legislation and a template e-mail and tweet that will go directly to your Federal elected officials. We encourage you to send a message yourself, and share the link with your colleagues, friends, and family. We also are asking our members for input on how we should use this platform going forward.

We will continue to fight GME cuts and advocate for increased GME support and keep our members apprised of any relevant developments. For additional information, GNYHA has several position papers on these topics, links to which can be found below: