Memo to OMB Desk Officer

DATE: March 18, 2011

FROM: Reports Clearance Officer, HRSA

TO: Office of Information and Regulatory Affairs, OMB

Through: Office of Strategic Operations and Regulatory Affairs, CMS

SUBJECT: HRSA Request for Approval of the Children’s Hospitals Graduate Medical Education Payment Program (OMB # 0915-0247): Revision

The Health Resources and Services Administration (HRSA), Bureau of Health Professions (BHPR) is requesting Office of Management and Budget (OMB) review and approval of revisions made to the Children’s Hospitals Graduate Medical Education (CHGME) Payment Program. Furthermore, HRSA is requesting that this ICR package be approved by June 15, 2011 in order to have the revised forms loaded onto HRSA’s electronic system and released by July 1, 2011.

Centers for Medicare and Medicaid Services’ (CMS) final rule regarding Sections 5503, 5504, 5505 and 5506 of the Affordable Care Act of 2010 (Public Law 111-148) published in the Federal Register on Wednesday, November 24, 2010 (Vol. 75, No. 226), requires some modification of the data collection within the CHGME Payment Program application. While HRSA staff knew that this legislative change would impact the CHGME program, the application forms could not be reviewed until CMS policy changes were finalized on November 24, 2010, and then reviewed and assessed by the CHGME program.

The CHGME Payment Program application forms have been adjusted to accommodate changes to CMS policy regarding graduate medical education. In particular, two data items have been added to capture information regarding Section 5503 and a reporting table has been expanded to collect data related to Section 5504.

According to CMS final policy referenced above, hospitals (including children’s hospitals) will be required to begin reporting additional data within their Medicare cost reports for periods ending on or after July 1, 2010. As required by statute ( Children's Hospitals GME Support Reauthorization Act of 2006, Public Law 109-307), children’s hospitals must use data reported within their most recently filed Medicare cost report to complete the CHGME application for funding. These data will include information related to Sections 5503 and 5504 of the ACA.

The CHGME program is required by statute to begin making payments to funded children’s hospitals by no later than October, 2011, the start of the fiscal year. CHGME applications are typically made available by July 1^st of each year and must be submitted on or before August 1^st. This timeframe allows program staff very limited time to process, review, and approve funding applications, and enter hospital data into the system to verify accuracy. It would be extremely difficult for CHGME staff to meet the statutory deadline if the revised applications are not released on schedule. To have these revised forms loaded onto HRSA’s electronic system and released by July 1, 2011, it would be necessary to have OMB approval no later than June 15, 2011.

Thank you.

Carla Haddad

Carla Haddad, MPH

Public Health Analyst

Office of Planning, Analysis and Evaluation

Health Resources and Services Administration

5600 Fishers Lane, Rm 10-49

Rockville, MD 20857

Phone: (301) 443-0165

Email: CHaddad@hrsa.gov