ACS Views on Legislative, Regulatory, and Other Issues

Graduate Medical Education—

• Background
• Other Activity: COGME and MedPAC
• Resident Work Hours

• ACS letter to The Honorable Phil English on the Higher Education Act, 5/24/05
• Letter to The Honorable Mark McClellan, MD, PhD, 6/12/04 (Re: Comments on Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2005 Rates, Proposed Rule [CMS-1428-P]
• ACS Letter to COGME on Workforce Study, 4/30/04
• Physician Coalition Senate Letter on Higher Education Act, 4/19/04
• Physician Coalition House Letter on Higher Education Act, 4/19/04
• ACS Senate Letter on Higher Education Act, 3/30/04
• ACS House Letter on Higher Education Act, 3/30/04
• Letter to Secretary Thompson on Unused Resident Positions, 3/8/04
• Letter to David C. Leach, 8/1/02
• Letter to David C. Leach, 6/6/02

March 8, 2004

The Honorable Tommy Thompson
Secretary
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201

Dear Secretary Thompson:

On behalf of the 66,000 Fellows of the American College of Surgeons, I would like to bring to your attention an important issue related to the implementation of Section 422 of the recently passed Medicare Prescription Drug and Modernization Act (MMA).

As you are aware, Section 422 directs the Secretary to redistribute a portion of hospitals' unused resident positions to teaching hospitals seeking to increase their resident limits. The law establishes a priority order for redistributing unused resident positions. In addition, the accompanying conference report authorizes the Secretary to consider giving special consideration to hospitals that train a large share of graduates from historically black medical colleges. (There was an error in the conference report so the sentence incorrectly says "large" medical colleges instead of "black," as Congress intended.)

We remain extremely concerned that the indirect medical education (IME) payments for the redistributed positions will be based on a lower add-on adjustment of 2.7 percent, rather than the IME adjustment rate for existing positions of 5.8 percent in FY 2005, 5.55 percent in FY 2006, 5.35 percent in FY 2007 and 5.5 percent in FY 2008 and beyond. However, we respectfully ask for your commitment to abide by Congressional intent and apportion an adequate number of the unused resident positions to hospitals affiliated with historically black medical colleges.

Under your leadership, the Department of Health and Human Services has demonstrated a strong commitment to eliminating health disparities. Historically black colleges and universities play a vital role in this effort as they graduate a disproportionate number of physicians who practice in medically underserved areas.

There are only four historically black medical colleges in the country: Meharry Medical College in Nashville, TN, Drew University in Los Angeles, CA, Morehouse College in Atlanta, GA, and Howard University in Washington, DC. At present, the inadequate number of resident training positions available to Meharry and Drew threaten their accreditation and very existence.

We look forward to working with you to resolve these serious challenges facing historically black medical colleges. If you have any additional questions, please contact Jennette Lawrence in our Washington office at 202-672-1517.

Sincerely,

Thomas R. Russell, MD FACS
Executive Director

Revised March 7, 2005

ACS Views on Legislative, Regulatory, and Other Issues

Advocacy and Health Policy