The AAMC has submitted a comment letter to the Centers for Medicare and Medicaid Services on a proposed rule that would modify current policies regarding Medicare direct graduate medical education and indirect medical education reimbursement for residents training in nonhospital sites. Medicare currently authorizes teaching hospitals to receive DGME and IME payments associated with residents training in nonhospital sites, such as physicians' offices, if the hospitals incur "all or substantially all" of the training costs.

According to the CMS, the goal of the proposed rule is to be responsive to "concerns expressed by the teaching hospital community about the administrative burden" of complying with current policies, in particular the requirement that hospitals must pay physician supervisory costs at the nonhospital site. In its comment letter, the AAMC notes that the proposed rule is not the "solution" that the academic medical community is seeking because it does not recognize that many physicians are willing to volunteer as supervisors and, therefore, the association believes there are no supervisory costs the hospitals need to pay. However, the AAMC points out that the proposed rule has the potential to significantly reduce the administrative burden of compliance and provides additional comments on how the rule could be further improved.  For more information, please visit http://www.aamc.org/advocacy/library/teachhosp/corres/2007/032607.pdf.