Distribution of GME Residency Positions Under Section 126 of the Consolidated Appropriations Act (CAA), 2021, and Section 4122 of the CAA, 2023 (CMS-10790)

Section 126 of the Consolidated Appropriations Act (CAA), 2020 (Public Law 116-93), enacted December 20, 2020, included a key provision affecting Medicare payments for Graduate Medical Education (GME). Section 126(a) of the CAA amended section 1886(h) of the Act by adding a new section 1886(h)(9) requiring the distribution of additional residency positions (slots) to qualifying hospitals. Section 1886(h)(9)(A) of the law makes an additional 1,000 Medicare funded residency slots available. Section 1886(h)(9)(B) requires that at least 10 percent of the aggregate number of slots be distributed to hospitals in four categories: (1) hospitals in rural areas (or treated as being located in a rural area under the law), (2) hospitals currently operating over their GME cap, (3) hospitals in states with new medical schools or additional locations, and (4) hospitals that serve areas designated as health professional shortage areas. Additionally, section 1886(h)(9)(C) places certain limitations on the distribution of the residency positions. Eligible teaching hospitals submit applications under this collection for the available slots and CMS staff reviews the applications and supporting documents to determine the validity of the hospitals’ requests for Medicare funded residency slots requested in accordance with Section 126 of the Consolidated Appropriations Act, 2020 (Public Law 116-93) prior to awarding the slots.

The latest form for Distribution of GME Residency Positions Under Section 126 of the Consolidated Appropriations Act (CAA), 2021, and Section 4122 of the CAA, 2023 (CMS-10790) expires 2027-11-30 and can be found here.

GME Applications

Federal Enterprise Architecture: Health - Health Care Services

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