Household Bill Calls For Greatest GME Slots Increase in Decades

The House of Representatives version of President Joe Biden’s domestic policy includes what hospitals have been pushing for decades: thousands of additional Medicare-funded accommodations.

If accepted, it will be the largest expansion of the postgraduate medical education program in decades and a victory for hospital groups that predict an impending shortage of doctors caused by an aging population and retiring doctors.

The question is whether 4,000 new seats will remain after the bill goes to the Senate, where Democrats must make tough priority choices in order to win the approval of more moderate members of their faction.

“COVID did exacerbate staffing problems, especially on the part of doctors, but then it became the entire healthcare world,” said John Cooper, senior vice president of government affairs, communications and public policy at the Greater New York City Hospital Association. “This created a situation where both the House of Representatives and the Senate wanted to go further and do something more.”

The House of Representatives has yet to vote on the $ 1.75 trillion domestic policy package that Biden and Democrats in Congress have called the “Recovery Efficiency Act,” and it’s unclear when that will happen.

House Speaker Nancy Pelosi, Calif., Had hoped to hold a vote on Friday, but a handful of moderate Democrats demanded an analysis from the nonpartisan Congressional budget office before moving on.

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The House bill is expected to be relatively similar to what the Senate will ultimately consider. Democratic leaders in both chambers worked closely to craft an agreement that could pass.

The GME provisions have strong supporters on both sides in the Senate, including Majority Leader Chuck Schumer (DN.Y.) and Budget Committee Chairman Bernie Sanders (I-Vt.), And are not considered controversial.

However, the bill includes fewer than 14,000 new groups of GME slot providers seeking to alleviate the worsening physician shortage, which the Association of American Medical Colleges projects will reach 40,000 by 2034.

“We understand that clearly not everyone got what they wanted,” said Leonard Marquez, senior director of government relations and legislative protection at the AAMC. “Ultimately, where they end up will go a long way towards improving patient access to care and helping to diversify the workforce.”

New Medicare-funded temporary accommodations have been a priority for hospitals for decades since Congress, worried about wasteful spending and creating surplus doctors, essentially froze new temporary accommodations in 1997.

While the AAMC and other groups have pushed for GME expansion for several years, COVID-19 has prompted lawmakers to take action.

As part of the COVID-19 Relief Bill passed in December, Congress and President Donald Trump lifted a multi-year freeze and added 1,000 new Medicare GME slots. This law specifies what percentage of these slots will be allocated to rural and underserved areas, new medical schools and hospitals that are training beyond Medicare limits. Medicare and Medicaid Service Centers have not yet finalized a rule to apply this part of the law.

A pending House bill prescribes how time slots will be allocated in a similar pattern, but also prioritizes primary health care and psychiatry, an exciting group of health care providers who have sought to make these changes to the GME program. During the first two allocation cycles, 25% of new places should be allocated for primary health care residency and 15% should be allocated for psychiatry residency.

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