Association of American Medical Colleges (AAMC)
The AAMC and the medical schools, teaching hospitals, academic and professional societies, faculty, residents, and students we represent are committed to improving the nation's health through medical education, research, and high-quality patient care. We are dedicated to the communities we serve, committed to advancing the public good, and steadfast in our desire to earn and keep the public's trust for the role we are privileged to play in our society.
On May 23, 2007, the Centers for Medicare and Medicaid Services (CMS) issued proposed rules that would eliminate federal matching funds for Medicaid graduate medical education (GME) payments to the nation’s teaching hospitals.
The CMS has also finalized a second rule that imposes new restrictions on payments to health care providers operated by
units of governments that will eliminate another key source of Medicaid funding.
Unless Congress acts to stop these rules beforeMay 25, U.S. teaching hospitals in 47 states and the District of Columbia will lose at least $1.7 billion in federal GME support, jeopardizing the physician training and vital patient care services on which all Americans depend.
The bulk (83 percent) of NIH-supported research is conducted through 50,000 grants awarded to 325,000 researchers at more than 3,000 institutions (extramural research); more than half of all extramural funding supports researchers at the nation’s medical schools and many major teaching hospitals. About 10 percent of the NIH budget supports intramural research, or research conducted by the NIH’s 6,000 scientists in its own laboratories, while the remaining 7 percent supports research management and other activities.
On May 23 CMS issued a proposed rule asserting that Medicaid lacks the “statutory authority” to match payments for graduate medical education (GME) activities. Specifically, if this proposed “GME Rule” were implemented, states would not receive federal Medicaid matching payments for direct graduate medical education (DGME).
CMS estimated that eliminating the federal Medicaid match for DGME would reduce federal outlays by an estimated $1.78 billion over 5 years. Congress responded by imposing a one-year moratorium prohibiting (until May 25, 2008) implementation of the proposed GME rule, as well as implementation of the final rule on Medicaid cost limits/units of government (the “IGT Final Rule”). The proposed GME rule and the IGT final rule are among several regulatory changes issued by CMS in the past year. The other rules affect payments for outpatient care, school/community-based services, and rehabilitation.