Children"s Hospitals Graduate Medical Education Payment

The Children"s Hospitals Graduate Medical Education Payment Program (CHGMEPP) provides funds to children"s teaching hospitals to support the training of pediatric and other residents in graduate medical education (GME) programs.

Since Federal financial support of graduate medical education is
extensively supported by the Medicare system, the CHGME program compensates for the disparity in the level of Federal funding for pediatric teaching hospitals versus other types of teaching hospitals.

The Secretary of DHHS has delegated the authority for the administration of the CHGME payment program to Health Resources and Services Administration (HRSA), which redelegated it to the Bureau of Health Professions (BHP).

Agency - Department of Health and Human Services

The Department of Health and Human Services is the Federal government's principal agency for protecting the health of all Americans and providing essential human services, especially to those who are least able to help themselves.

Office - See Regional Agency Offices.

Daniel Mareck, MD, Director, Division of Medicine and Dentistry, Bureau of Health Professions, Health Resources and Services Administration, Department of Health and Human Services, 5600 Fishers Lane, Room 9A-27, Rockville, MD 20857.

Telephone: (301) 443-6190.


Program Accomplishments

Fiscal Year 2008: The CHGME Payment Program made awards to 56 eligible children"s teaching hospitals in FY 08. Fiscal Year 2009: It is estimated that awards will be made to 56 eligible teaching hospitals in FY 09 and FY 10. Fiscal Year 2010: No Current Data Available

Uses and Use Restrictions

Funds are restricted to eligible children"s hospitals for direct expenses and the other indirect expenses associated with operating approved graduate medical residency programs.

Eligibility Requirements

Applicant Eligibility

Local (includes State-designated lndian Tribes, excludes institutions of higher education and hospitals: Health/Medical

Beneficiary Eligibility

Public nonprofit institution/organization; Other public institution/organization; Profit organization; Private nonprofit institution/organization; Quasi-public nonprofit organization

Credentials/Documentation

Applicants should review the individual HRSA Guidance documents issued under this CFDA program for any required proof or certifications which must be submitted prior to or simultaneous with submission of an application package. This program is excluded from coverage under OMB Circular No. A-87.

Aplication and Award Process

Preapplication Coordination

Preapplication coordination is required.

Environmental impact information is not required for this program.

This program is excluded from coverage under E.O.

12372.

Application Procedures

This program is excluded from coverage under OMB Circular No. A-102. OMB Circular No. A-110 applies to this program. HRSA requires all applicants to apply electronically through Grants.gov.

All qualified applications will be forwarded to an objective review committee. Based on the advice of the objective review committee, the HRSA program official with delegated authority is responsible for final selection and funding decisions.

Award Procedures

Notification is made in writing by a Notice of Grant Award.

Deadlines

Contact the headquarters or regional office, as appropriate, for application deadlines.

Authorization

Public Health Service Act, Title III Part D, Section 340E, 42 U.S.C. 256E, as amended; The Children"s Health Act, 2000, Public Law 106-310, Healthcare Research and Quality Act, 1999, Public Law 106-129; as amended; Public Law 109 -307; Social Security Act.

Range of Approval/Disapproval Time

Not Applicable.

Appeals

Hospitals can appeal the determination of FTE resident counts by CHGME fiscal intermediaries to the Provider Reimbursement Review Board (PRRB) under section 1878 of the Social Security Act.

Renewals

Eligible children"s hospitals must complete a CHGME Payment Program application for inclusion in the program for each fiscal year that they are applying for funds.

Assistance Considerations

Formula and Matching Requirements

Statutory formulas are not applicable to this program.

Matching requirements are not applicable to this program.

MOE requirements are not applicable to this program.

Length and Time Phasing of Assistance

In accordance with the Healthcare Research and Quality Act, 1999, Public Law 106-129, the Secretary of DHHS shall determine before the beginning of each fiscal year that payments are made for a hospital. The amounts of the payments for direct and indirect medical education are made to each hospital in 12 equal interim installments during the period. The Children"s Health Act, Public Law 106-310, amends the length of the CHGME Payment Program through fiscal year 2005. Public Law 109-307 re-authorizes the program, through fiscal year 2011. . See the following for information on how assistance is awarded/released: Grantees drawdown funds, as necessary, from the Payment Management System (PMS). PMS is the centralized web based payment system for HHS awards.

Post Assistance Requirements

Reports

Public Law 109-307 requires children s hospitals receiving CHGME funds to submit an annual report that focuses on their GME training program.

The Department has to submit a report to Congress by 2011.

No cash reports are required.

No progress reports are required.

No expenditure reports are required.

No performance monitoring is required.

Audits

In accordance with the provisions of OMB Circular No. A-133 (Revised, June 27, 2003), "Audits of States, Local Governments, and Non-Profit Organizations," nonfederal entities that expend financial assistance of $500,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133. In accordance with the provisions of OMB Circular No. A-133 (Revised, June 27, 2003), "Audits of States, Local Governments, and Nonprofit Organizations," nonfederal entities that expend financial assistance of $500,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133.

Records

Grantees are required to maintain grant accounting records for 3 years after the date they submit the FSR. If any litigation, claim, negotiation, audit, or other action involving the award has been started before the expiration of the 3-year period, the records shall be retained until completion of the action and resolution of all issues which arise from it, or until the end of the regular 3-year period, whichever is later.

Financial Information

Account Identification

75-0350-0-1-550.

Obigations

(Direct Payments for Specified Use) FY 08 $297,000,000; FY 09 est $310,000,000; FY 10 est $310,000,000

Range and Average of Financial Assistance

$23,018.48 to $21,772,172.85 ; $5,055,989.46 in combined DME and IME payments.

Regulations, Guidelines, and Literature

Healthcare Research and Quality Act, 1999 (Public Law 106-129), Section 340E of the Public Health Service Act; The Children"s Health Act, 2000 (Public Law 106-310, Title XX); Public Law 108-490; Public Law 109-307; Social Security Act, Section 1886, 42 CFR 412.105; 42 CFR 413.86; FRN Vol. 65, No. 118 published on June 19, 2000; FRN Vol. 66, No. 41 published on March 1, 2001; and FRN Vol. 66, No. 140 published on July 20, 2001, and FRN Vol. 68, No. 204, published on October 22, 2003.

Information Contacts

Regional or Local Office

See Regional Agency Offices. Daniel Mareck, MD, Director, Division of Medicine and Dentistry, Bureau of Health Professions, Health Resources and Services Administration, Department of Health and Human Services, 5600 Fishers Lane, Room 9A-27, Rockville, MD 20857. Telephone: (301) 443-6190.

Headquarters Office

Rick Goodman 5600 Fishers Lane, Room 11A-16, Rockville, Maryland 20857 Phone: (301) 443-2728

Criteria for Selecting Proposals

Children"s teaching hospitals must meet all of the eligibility criteria before being considered for program funds and must be training residents during the year for which they are applying for funding. This is a noncompetitive annual award.



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