FFY 2024 IPPS Proposed Rule: Graduate Medical Education (GME)

On April 10, the Centers for Medicare & Medicaid Services (CMS) published the FFY 2024 IPPS Proposed Rule (effective for discharges on or after October 1, 2023).” Toyon is pleased to provide our summary of Section 7: FFY 2024 IPPS Proposed Rule: Graduate Medical Education (GME) for CYs 2010-2019.

Medicare Advantage Allied Health Payments

In response to Section 4143 of the Consolidated Appropriations Act, 2023 (CAA, 2023), CMS published the recalculated Nursing and Allied Health Education Payment Pools for Medicare Advantage (MA) funding for calendar years 2010 through 2019 only (see Table 6 below). MACs are instructed to initiate the revised payments for hospitals’ eligible cost reporting years. The eligibility criteria include that 1) a hospital’s cost report is within the three-year reopening period as of 12/29/20228 and 2) the Allied Health program(s) were in operation as of 12/29/2022. In addition, this change does not affect the percent reduction to MA GME funding (i.e., there are no changes to the DGME MA percent reduction amounts9). For CY 2020 and subsequent years, the MA Nursing and Allied Health Education Payment pool reverts back to the original $60 million.

Table 5: Changes to MA Allied Health Payment Pool


8Transmittal 11904 – Implementation of Consolidated Appropriations Act (CAA) of 2023, Section 4143: Waiver of Cap on Annual Payments for Nursing and Allied Health Education Payments

9As specified in Change Request (CR) 11642 for CYs 2010 through 2017, CR 11642 for CY 2018, and CR 12407 for CY 2019.

Comments are due to CMS by Friday, June 9 via https://www.regulations.gov/ (see instructions under the “submit a comment” tab and reference file code “CMS-1785-P”). Toyon will share our comment letter in the coming weeks.

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FFY 2024 IPPS Proposed Rule: Wage Index

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FFY 2024 IPPS Proposed Rule: Low-Volume Adjustment