Graduate Medical Education for Dental Residents Claimed by the University of Louisville Hospital for Fiscal Years 2000 Through 2002

EXECUTIVE SUMMARY:

Our objective was to determine whether University of Louisville 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.  Although the Hospital appropriately included dental residents in its FTE counts used to compute FYs 2000 and 2001 GME payments, in FY 2002 the Hospital inappropriately included a dental resident who was a graduate of a foreign dental school.  As a result, the Hospital overstated its direct and indirect GME claims by $15,759 for FY 2002.  The Hospital also included didactic, i.e., classroom, time for the residents when working in nonhospital settings. 

We recommended that the Hospital:  (1) file an amended cost report to refund $15,759, (2) establish and follow procedures for foreign dental school graduates, (3) determine whether similar errors occurred after FY 2002 and refund any overpayments, and (4) work with CMS to resolve the $139,704 related to FYs 2000 through 2002 FTEs for the didactic time of residents assigned to nonhospital settings.  The Hospital concurred with our first, third, and fourth recommendations.