Chapter 195-18 INTERNAL MEDICINE RESIDENCY CAPITATION

Rule 195-18-.01 General Definitions

"Internal Medicine Residency Program" is a three year training program after graduation from medical school designed to provide the experience required to train an internal medicine physician as delineated by the Accreditation Council for Graduate Medical Education, Essentials for Residency Programs in Internal Medicine.

(2)	"Accreditation Council for Graduate Medical Education" is the body established to accredit residency programs.

(3)	"Essentials of Accredited Residencies in Graduate Medical Education," a document published by the American Medical Association in its annual Graduate Medical Education Directory, details the institutional and program requirements for each of the medical specialties and subspecialties.

(4)

"Qualified Hospital" means a hospital, or associated hospitals, which meet(s) the Residency Review Committee of the Accreditation Council for Graduate Medical Education requirements for a critical mass and mix of hospital patients, medical staff, facilities, and financial support adequate to sustain a quality program of internal medicine resident training.

(5)	"Underserved Areas" are those geographic areas of the state in which the Board determines there is a shortage of internal medicine physicians.

(6)	"Resident" means an individual at any level in an ACGME-accredited Graduate Medical Education Program, including subspecialty programs.

(7)	"Capitation" means Board funding of designated Internal Medicine Residency Training Programs based upon a fixed dollar amount per resident times the number of residents in training, with the fixed dollar amount being set by the total state appropriation available for this purpose.

(8)	"Board Programs" means those medical education activities supported by the Board and/or funded by the General Assembly to address Georgia's physician workforce needs.

Rule 195-18-.02 Internal Medicine Residency Capitation Funding

(1)

For the annual provision of capitation funds to designated Internal Medicine Residency Programs, the Board requires the following conditions be met:

(a)	Notification of the total number of residents to be trained during an academic year;

(b)	Maintenance of approval of the Program by the Accreditation Council for Graduate Medical Education;

(c)	Compliance with all Board guidelines, rules, and regulations;

(d)

Submission of all reports including, but not limited to, a graduate practice location report, and such other documents as may be reasonably required by the Board and/or outlined in the Georgia Board of Health Care Workforce Report Guidelines;

1.

Practice Location of Graduates. The medical school and/or Internal Medicine Residency Program shall annually submit a report to the Board indicating the practice location of each graduate to assist the Board in evaluating the effectiveness of the Program in meeting the need for physicians in Georgia.

(i)

Graduate practice location reports shall be due no later than September 1^st of each year and include the practice location (city/state), additional training being pursued (e.g., fellowship), military service obligation, other state or federal service obligation (e.g., Georgia Board of Health Care Workforce, National Health Services Corp.), or other activity of those residents completing their medical education and training at the medical school or Internal Medicine Residency Program.

(ii)	Medical Schools/Internal Medicine Residency Programs shall be expected to monitor, update, and report to the Board, any changes in the practice status of graduates for a period of five years post-graduation.

(e)	Development and maintenance of procedures to encourage residents to establish practices in areas of Georgia where unmet need exists for internal medicine physicians; and collaboration to maximize state resources, where appropriate, to carry out said activities.

(2)

Payment Process. Based on the Resident Monthly Updates submitted by the Internal Medicine Residency Program, the Board shall authorize disbursement of internal medicine residency capitation funding in quarterly installments.

(a)

The Program shall report on the Resident Monthly Updates, resident's name, social security number, anticipated date of graduation, post-graduate year, and indication of resident participation during report period. Such reports shall be submitted no later than the tenth (10) day of the following month.

(b)	Capitation payment shall not be made for any one resident in excess of thirty-six months.

(c)	Payment will not be made for any resident on an unpaid leave of absence.

(d)	Payment for a resident who must extend his/her training over a period in excess of three (3) years will be authorized by the Board pending availability of funds.

(3)

State Audit. The Medical School and/or Internal Medicine Residency Program shall be subject to an audit of the financial records relating to the Internal Medicine Residency Capitation Funding upon request of the Board or other duly authorized officer or employee of the State of Georgia upon reasonable request. For this purpose, the Medical School and/or Internal Medicine Residency Program shall:

(a)	Maintain for three (3) years after receipt of Internal Medicine Residency Capitation Funding, all directly pertinent books, documents, papers, and records involving related transactions;

(b)	To account for the State funds received through the Internal Medicine Residency Capitation Agreement in the next "Certified Independent Auditors Report" or in "Audited Financial Statements" of the Hospital.

(c)	Retain sufficient records for the conduct of an audit for any year for which payments are in dispute until such dispute is resolved;

(d)	Be subject to reduction in payment of Internal Medicine Residency Capitation Funding based on the findings of a state audit disallowing any previous such payment; and

(e)	Maintain a permanent personnel file on each resident who graduates from the Program which shall include a record of the resident's experience during the training period and evaluations of their performance by faculty and other supervisors.

(4)

Retention of Graduates. The practice location of graduates will be monitored by the Board for five (5) years from date of graduation. In the event retention of graduates practicing in Georgia should fall below an acceptable number, over any five (5) consecutive year period, the Board shall have the authority to adjust the rate of capitation paid to said Program. The acceptable rate of retention will be determined by the Board from time to time and set forth in the Agreement between the Board and the Medical School and/or Internal Medicine Residency Program.

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