Graduate Medical Education for Dental Residents Claimed by Boston Medical Center for Fiscal Years 2000 Through 2002

EXECUTIVE SUMMARY:

Our objective was to determine whether Boston Medical Center (the Hospital) included the appropriate number of dental residents in its full time equivalent (FTE) counts when computing Medicare graduate medical education (GME) payments for fiscal years (FYs) 2000 through 2002.  The Hospital inappropriately included a total of 120.15 direct GME FTEs and 113.80 indirect GME FTEs in the counts for FYs 2001 and 2002 without incurring all of the costs of training dental residents in nonhospital sites. 

We recommended that the Hospital:  (1) file an amended cost report, which will result in a refund of the $4,927,120 associated with FTEs for which the Hospital did not incur all or substantially all of the training costs, (2) establish and follow written procedures to ensure that the FTE counts for residents in nonhospital settings include only those FTEs for which the Hospital has incurred all or substantially all of the training costs, and (3) determine whether errors similar to those identified in our review occurred in Medicare cost reports after FY 2002 and refund any overpayments.  The Hospital generally disagreed with our findings and recommendations related to FY 2002, but did not address our findings and recommendations for FY 2001.