CHGME Payment Program > ALERT — FY 2010 Initial Application Cycle

The FY 2010 initial application for CHGME Payment Program will be available (online) on or about July 1, 2009. All applications are due on or before August 1, 2009.

If you are new to your organization you will be asked to complete the HRSA Security Training online prior to doing your reconciliation application.  Please notify your regional manager for further direction.

To complete your application, please log onto https://chgmeapplication.hrsa.gov/default.asp and read the Rules of Behavior online, check off that you have had security training (item number 2) and select “Accept” at the bottom of the document. You will then be able to log into the system and then reset your password.

The CHGME Payment Program will be available to answer questions and help you through this process.  If you are having difficulty, please contact your RM for help.

Interim payments to each hospital shall be based on the number of residents reported in the hospitals most recently filed Medicare Cost Report (MCR), and residents reported in the prior two MCR years.  Any hospital that does not report residents on a MCR, payments will be based on the number of residents trained during the hospital’s most recently completed MCR filing period and residents claimed in prior two MCR years . (P.L. 106-310, October 17, 2000.)

• If the fully filed MCR is “settled” by Medicare before the initial application due date for the CHGME Payment Program, the number of residents claimed in the settled or re-settled MCR must be used for compliance with the legislative mandate cited above.
• For hospitals filing full MCRs, and the MCR is not settled or re-settled, the CHGME Payment Program will use the FTE resident counts from the CHGME FI FTE final report or the “As Filed (AF)” MCR reports.
• For hospitals filing low/no utilization MCRs, the FTE resident counts should match the CHGME FI FTE final report from the latest assessment or the most recently completed MCR.

As you are aware, on October 6, 2006, the President signed the Children’s Hospital Graduate Medical Education (CHGME) Support Reauthorization Act of 2006 (herein after “the Act”) which amended Section 340E of the Public Health Service Act.  The Act requires the program to update the wage index (WI) annually, as applied under section 1886(d)(3)(E) of the Social Security Act, in its determination of payments using the Centers for Medicare and Medicaid Services (CMS) published WI for the preceding year.  You will receive a notice mid July with your new wage index for signature and will be requested to fax or “pdf” that form back to the CHGME Payment Program.  The wage index as applied under section 1886(d)(3)(E) of the Social Security Act is computed by CMS and will be provided to you.

Children's hospitals requesting funding for the FY 2010 application cycle, must submit a case mix index (CMI) based on the discharges from the most recently filed MCR for hospitals that file full MCRs or the most recently completed MCR period for hospitals that file low or no-utilization MCRs, using CMS-DRG Version 25 with the appropriate CMS Version 25 weights reported to the ten-thousandth decimal place.

This is to remind you that the disbursement of payments to Children’s Hospitals for both direct and indirect graduate medical education payments will be available through the Grant Payment Management System (PMS).  The PMS is a centralized grants payment and cash management system, operated by the HHS Program Support Center (PSC), Division of Payment Management (DPM). The PMS accomplishes all payment-related activities for HHS grants from the time of award through closeout. Under this system, recipients (children’s hospitals participating in the CHGME Payment Program) will be responsible for drawing down their monthly allotted payments and complying with all rules, regulations, and policies associated with the PMS. 

Starting with July, children’s hospitals will have to draw down their own monthly funds following terms and conditions specified by a Notice of Grant Award (NGA).  There will be a ‘welcome’ packet sent to each of the assigned hospital contacts that was collected earlier in the year. This information packet will be sent by the HRSA grant office and will supply the user of PMS with their PIN, instructions on how to navigate through the system and draw down their funds, and a contact person for questions or help concerning the draw downs. The NGA will replace the notice of award letters and vouchers that were previously sent by the program. These NGA’s will be sent via email to the person from your facility that has the authority to draw down the monthly funds.  The NGAs will be sent by the staff in the Division of Grants Management and not by CHGME program staff.

The Electronic Handbooks (EHBs) system is an enterprise wide project management system allowing the agency to accomplish its mission of improving access to health care through grants and cooperative agreements to State and local government, health care providers, and health professions training programs. The EHBs have been designed to support HRSA’s mission critical business functions spanning program administration, monitoring, management reporting, performance measurement and analysis, and grants administration. It allows HRSA to operate in a paperless fashion in a more efficient way and in compliance with the mandated Agency-wide and Federal policies, procedures, and legislations. The HRSA EHBs system is owned by the Office of Federal Assistance Management (OFAM).

The CHGME Payment Program will be to moving towards a full integration with this system over the course of three to five years. Eligibility, applications, and processes for disbursements will not change.  However, applications, reviews, completions will be ultimately be done through the EHB.  Each of the children’s hospitals applying for funds will (1) register through grants.gov, and once registration is reviewed and complete the hospital will then log into the EHB system and apply for CHGME funds using the CHGME application.  This transition is expected to afford HRSA and the Department oversight for the CHGME Payment Program.  The program will continue to assist you as we transition to this new system.

As always, if additional information or assistance is needed, please contact your CHGME PP designated regional manager: