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Duplicate Graduate Medical Education Payments

Medicare pays teaching hospitals for direct graduate medical education (DGME) and indirect medical education (IME) costs. When payments for DGME and IME costs are being calculated, no intern or resident may be counted by Medicare as more than one full-time equivalent (FTE) employee (42 CFR §§ 413.78(b) and 412.105(f)(1)(iii)). To ensure that this incorrect counting does not occur, Centers for Medicare & Medicaid Services created the Intern and Resident Information System (IRIS). Prior OIG reviews determined that hospitals received duplicate reimbursement for DGME costs. We will review provider data from IRIS to determine whether hospitals received duplicate or excessive DGME payments. We will also assess the effectiveness of IRIS in preventing duplicate payments for DGME costs. If duplicate payments were claimed, we will determine which payment was appropriate.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
October 2017 Centers for Medicare & Medicaid Services Duplicate Graduate Medical Education Payments Office of Audit Services W-00-15-35432; W-00-17-35432; various reviews 2019