Indirect Medical Education (IME) and Supporting Regulations 42 CFR 412.105

Attachment 2
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Read Me First File* (rfudedv3.pdf)
*- Updated October 2015
Important Information for Installing and Operating the IRISEDV3 Program:
Before downloading Version 1.1 of the IRISEDV3 program from the CMS web site (www.cms.gov\Research-StatisticsData-and-Systems/Computer-Data-and-Systems/IRIS), read the entire contents of this file as shown below:
Contents
1. Required Equipment
2. Additional Software Required to Run IRISEDV3
3. Installation
4. Operation
5. Excerpts from IRISV3 Operating Instructions
6. Printing IRISEDV3 Reports
7. Incorrect Data on IRIS Diskettes/CDs
8. Modification of Data on IRIS Diskettes/CDs
9. Description of Changes/Modifications to April ’02 Release, IRISEDV3
10. December 2005 Updates to October ’03 Release, IRISEDV3
11. February 2009 Updates to October ’03 Release, IRISEDV3
12. April 2010 Updates to October ’03 Release, IRISEDV3
13. December 2011 Updates to October ’03 Release, IRISEDV3
14. August 2012 Updates to October ’03 Release, IRISEDV3
15. February 2014 Updates to October ’03 Release, IRISEDV3
16. August 2014 Updates to October ’03 Release, IRISEDV3
17. October 2015 Updates to October ’03 Release, IRISEDV3
18. Concluding Remarks
1. Required Equipment
This section describes the computer hardware needed to run IRISEDV3. IRISEDV3 will run on any modern 100% IBM
compatible personal computer (PC) equipped with:

•

[REQUIRED] A 3.5 inch disk drive or CD-R/RW drive.

•

[REQUIRED] A fixed (hard) drive with at least 10 megabytes of dedicated space available and 8 megabytes of
random access memory (RAM).

•

[REQUIRED] A PC compatible printer with an LPT1 (parallel) port, preferably one that can print at twelve
characters per inch.
If the printer has an LPT1 (parallel) port and other port(s) such as USB, use a parallel cable with a plug (usually
25 pins) for the LPT1 port on the printer and a parallel/USB plug for the PC.
If the printer only has an USB port, refer to Item Number 6(a) below for printing IRISEDV3 reports from local
printers with USB ports.
If you do not have a local printer but you have access to a network printer, refer to Item Number 6(b) below for
printing IRISEDV3 reports from network printers.

Warning: IRISEDV3 is a single user program. In some cases it can be run from a network file server, but should
not be used in a multi-user environment (that is, with more than one user entering or changing data at the same
time).

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If necessary, scroll down to the bottom of this file for the configuration commands
Type the lines, or correct the lines or numbers on the lines as follows:
buffers=99
files=99

Click on File
Click on the Save button and click on "Yes" if "config.nt" already exists
Click on the Close button icon to leave the "config.nt" file
(3) Reboot or restart your computer to activate the changes you just made.
(c) The program is now installed and ready to use. Always move to the IRISEDV3 folder before executing the program.
To start IRISEDV3 from Windows Explorer, issue these commands:
Click on Windows Explorer
Click on My Computer
Click on the "irisedv3" folder in the C drive
There are 3 options for operating the IRISEDV3 program: 1) Double click on the "irisedv3.exe" file in the middle of the
IRISEDV3 folder; 2) click on the "irisedv3.exe" file and click "Open"; or 3) click on Start, click on Run, type "cmd"
and press the Enter key () to activate the DOS command screen, type "c:" and press , type
"cd\irisedv3" and press , type "irisedv3.exe" and press to run the IRISEDV3 program (note: after
exiting the IRISEDV3 program, type "exit" to leave the DOS command screen
If necessary, click on the Maximum button icon to enlarge the IRISEDV3 screens
(d) Program Initialization. The following steps must be performed the first time you run IRISEDV3. Do not attempt to
execute any other IRISEDV3 functions until this step is complete. Before proceeding, note that data entry in
IRISEDV3 is not case sensitive; that is, all alphabetic characters are presumed to be upper case.
Start IRISEDV3 as in 3.(c). above:
Select "Data Management" from the "IRIS DATA EVALUATION MENU" by pressing <2> and run the first two
procedures in the next menu that appears. The "IRIS REFERENCE DATA MANAGEMENT" menu reappears after
each procedure is completed.
(1) Initially select "Set up Administrative Data" by pressing <1>, and answer the prompts that appear on the
screen. (Note: The "Default:\ in which Provider data will be stored" is set
up as: "C:\IRISEDV3"; if a different drive letter is used to house the IRISEDV3 program, change the capitalized letter
in "C" to a different capitalized letter and press the key twice.) Then press the letter S to save the entered
data.
(2) Then select "Rebuild Data Indexes" by pressing <2>. This causes IRISEDV3 to create index files which
enable the program to search and display data in various orders that are required by the different program functions.
After completing these two procedures, select "Exit" by pressing .
4. Operation
You are now ready to run IRISEDV3. Select "Process One Provider's Data" by pressing <1>. At this point,
answer the prompts that appear on the screens and the program will begin evaluating master record and assignment
record(s) data for each reported resident. See Item Numbers 4(a) through (f) below for notes on program operation:
(a) IRISEDV3 only imports (accepts) IRISV3 produced master and assignment files or IRISV3 compatible master and
assignment files from IRIS diskettes/CDs in database file (DBF) format for fiscal years beginning on or after July 1, 1994.
It will not accept IRISV3 compatible master and assignment files from IRIS diskettes/CDs in command-separated

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values (CSV) file format. It will also not accept IRIS95 produced or compatible master and assignment files since they
contain incompatible data file structures and are not compliant with Y2K (i.e., millennium) requirements. The diskette/CD
is to contain two database files for one cost reporting period as follows: M3xxxxxx.dbf for the master file, and
A3xxxxxx.dbf for the assignment file ("xxxxxx" is the six-digit provider number). The master file should only contain ONE
master record for each reported resident, and the assignment file should contain at least ONE assignment record for each
reported resident.
(b) IRISEDV3 evaluates each set of master record and corresponding assignment record(s) for each reported resident. If
the master record and corresponding assignment record(s) pass all IRIS system edits, the message, "Record is
okay", will appear on the screen. This program will automatically continue its edit routine for the next set of records.
However, this program will stop if the next set does not pass all IRIS system edits and specific explanations for data
entry error or record rejection will appear on the screen. In addition, the message, "Press C to Continue" or
"Press any key to continue..." for IRISEDV3 program evaluation of the next set of records will also appear
on the screen. Before pressing the letter C (or any key to continue) on the keyboard, it is suggested that a screen
print (i.e., "print screen") be made of the explanations for record rejection for later correction of erroneous or invalid
records by providers**. If necessary, press the letter C (or any key to continue) again one or more times for
IRISEDV3 to move on to the next set of records for its evaluation of reported resident data.
**- Providers must correct rejected master and assignment records in the imported files since IRISEDV3 cannot be
used to make these corrections. Accordingly, these providers are to correct master and assignment records that are
listed in this part on the IRIS diskette/CD. In addition, IRISEDV3 will ignore assignment records that do not have
corresponding master records, and such assignment records will not appear in Part 3. In all cases, providers are to
run (and re-run, if necessary) the IRISEDV3 program on the corrected IRIS diskette/CD for producing a report of
records that passed all IRIS edits (Part 1 only).
(c) After IRISEDV3 evaluates the records in the master and assignment files, two options ("<1> - Proceed to Step
4 and <2> - Quit") appear for Step <4>, "Print Report of Evaluation and Edit - OPTIONAL".
Press <1> to open up the printing results menu, and press to accept default printing (option no. 2) of
assignment data for all records. The "IRISEDV3 EVALUATION OF IMPORTED IRIS DATA" report will produce a
3 part printout if the IRIS diskette/CD contains valid, erroneous, and invalid records, respectively. The part names
are: "Part 1 - New Records That Passed All IRIS Edits"; "Part 2 - Records That Failed One
or More IRIS Edits" (e.g., master record with invalid or blank residency type code); and "Part 3 - Invalid
Records" (e.g., assignment record with invalid or blank fiscal year begin date). If the IRIS diskette/CD contains
duplicate records in the master file, IRISEDV3 will produce an untitled and separate listing of these records in the
format "Uxxx-xx-xxxx; Occurrences: n" ("Uxxx-xx-xxxx" is the social security number and "n" is the number
of master records with the same SSN). These records are deemed invalid, and they are included in Part 3. Press
to exit IRISEDV3 after the printouts are completed.
(d) If the "IRISEDV3 EVALUATION OF IMPORTED IRIS DATA" report only produces Part 1, this means the files on
the IRIS diskette/CD successfully passed all IRIS system edits that are embedded in the IRISEDV3 program***.
Providers are to make an electronic file or diskette/CD copy of this diskette/CD for safekeeping and future reference,
and to send the IRIS diskette/CD to their servicing Part A Medicare Administrative Contractor (MAC) that is due at the
same time as their Medicare cost reports. (It is recommended that the provider furnish a hard copy printout of Part 1
along with the diskette/CD.) The MACs will evaluate the files on their diskette/CD copy, and they may request
providers to submit revised IRIS diskettes/CDs at any time in the future.
***- Providers must review Part 1 for assignment records which may require corrections. The reason is that
IRISEDV3 does not reject zero values or blanks in the “TIMEPERC”,"IMEPERC","GMEPERC", and “ARESYEAR” data
fields in the imported assignment file. Furthermore, it has also come to our attention that IRISEDV3 does not edit for
erroneous residency type codes in the “ARESTYPE” data field in the imported assignment file. Accordingly, these
providers are to correct these records that are listed in this part on the IRIS diskette/CD. IRISEDV3 will also ignore
assignment records that do not have corresponding master records, and such assignment records will not appear in
Part 3. In addition, it is important to note that IRISEDV3 does not perform edits of invalid numerical ranges for U.S.
Social Security Numbers (SSN) or invalid Canadian Social Insurance Numbers (SIN) in the “SSN” data field in the

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imported master and assignment files. It is suggested that providers print out articles on invalid SSNs and SINs (e.g.,
“SSN Wikipedia” and “social insurance number Wikipedia” via Google) before reviewing Part I for such numbers, and
to correct them in the imported master and assignment files. In all cases, providers are to run (and re-run, if
necessary) the IRISEDV3 program on the corrected IRIS diskette/CD for producing a report of records that passed all
IRIS edits (Part 1 only).
(e) If the "IRISEDV3 EVALUATION OF IMPORTED IRIS DATA" report produces Part 2 or Parts 2 and 3 along with or
without Part 1, this means the files on the IRIS diskette/CD failed one or more IRIS system edits that are embedded in
the IRISEDV3 program. Likewise providers are to make corrections to master and assignment records that are listed
in Parts 2 and 3 on the IRIS diskette/CD. Providers are to run (and re-run, if necessary) the IRISEDV3 program on
the corrected IRIS diskette/CD for producing a report of records that passed all IRIS edits (Part 1 only).
(f) It is important to rebuild the data indexes after running the IRISEDV3 program. This is accomplished by selecting
"Data Management" from the "IRIS DATA EVALUATION MENU" by pressing <2> and selecting "Rebuild Data
Indexes" in the "IRIS REFERENCE DATA MANAGEMENT" Menu by pressing <2>. Then select "Exit" by pressing
in this menu, and again select "Exit" by pressing in the "IRIS DATA EVALUATION MENU" to leave the
IRISEDV3 program.
In the meantime, see Item Number 6 below if you have difficulty printing IRISEDV3 reports.
5. Excerpts from IRISV3 Operating Instructions
A file copy of EXCERPTS FROM IRISV3 OPERATING INSTRUCTIONS (iredv3s9.pdf) is included in the new or updated
IRISEDV3 folder. It is also included in the CMS web site for IRIS. This file contains portions of the IRISV3 Operating
Instructions (medical school codes; residency type codes; help screens for data entry instructions; required master and
assignment file structures for IRIS diskettes/CDs; and IRISV3 program changes) in support of the IRISV3 program. To
obtain a printout of this information, use Adobe Acrobat X or Reader X (Version 10 or later version) to open up this file and
print it in HP LaserJet or equivalent mode for best results.
6. Printing IRISEDV3 Reports
(a) Local printers. Some users may experience difficulties in getting Windows to print reports from their locally attached
printer. It is suggested that you make arrangements with a member of your organization's technical support and have
them consider these selections as a possible solution to printing reports from the IRISEDV3 program as follows:
(1) For PCs with Windows 9x Family of Operating Systems:
Click on Start, point to Settings, click on Printers, and click your right mouse button on the local printer icon
Click on Properties
Click on Details and click on the Port Settings button
If necessary, remove the check mark from both settings in the "Configure LPT Port" screen and click the OK
button
Click on Spool Settings, click on Print Directly to Printer, and click the OK button
Click on the Close button icon to leave the "Properties" and "Printers" screens
It is also suggested that you or your organization's technical support person contact your printer's manufacturer or
visit their website for guidance on how to print from a DOS application on Windows 95, 98 or ME.
(2) For PCs with Windows NT Family of Operating Systems:
Click on Start, point to Settings, click on Printers, and click your right mouse button on the local printer icon
Click on Properties
Click on Advanced, click on Print Directly to Printer, and click the OK button
Click on the Close button icon to leave the "Properties" and "Printers" screens

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or
NET USE LPT1*”\\servername\printersharename”*/persistent:yes
[*-denotes a single space, not the character “*”]
An example of a server name is “cospooler”, and an example of a printer share name is “COC3-09-23 (PCL)”.
These names must come from within your PC’s Windows Control Panel, and these names are usually listed on
the Windows Printer Test Page. It is suggested that you print out this page for your reference.
Before starting any DOS applications, issue the above command from a command line. Specifically, run this
command line by clicking on the Start button and selecting the Run option. In the "Open" field, type “cmd”, then
click on "OK". This will start a Command Line session.
To end a Command Line session, type “exit” and press the Enter key.
In the meantime, if you wish to restore LPT1 as a local printer, the command line to use is:
NET USE LPT1/DELETE
or
NET USE LPT1*/DELETE
[*-denotes a single space, not the character “*”]
7. Incorrect Data on IRIS Diskettes/CDs
We realized that not all providers enter correct data for certain data fields in master and assignment files. Such data on
IRIS diskettes/CDs will pass all IRIS system edits. These data fields are:
(a) Residency Year. Providers have entered incorrect year data for both residency year fields in master and assignment
files. For example, providers entered program year levels instead of the number of residency years completed in all
types of approved programs in residency year fields. The effect of this type of error is usually the difference of one
year (e.g., program year level 3 may indicate at least 2 years completion of approved programs). MACs may evaluate
the files for this type of error on their IRIS diskette/CD copies, and they may request providers to submit revised IRIS
diskettes/CDs at any time in the future.
(b) Full-Time/Part-Time. Providers have entered percentages less than 100 percent (%) for the full-time or part-time
percentage or "TIMEPERC" data field in the assignment file. Most residents work on a full time basis, and many of
them rotate between two or more hospitals on a daily or longer basis. If that is the case, then this field should
be the number 100. For example, a resident spent half the time at Hospital "A" and half the time at Hospital "B".
Hospital "A" reported this time correctly in the IRIS diskette/CD as 100% full time and 50% IME/GME. Hospital "B"
incorrectly reported this time as 50% part time and 100% IME/GME; Hospital "B" should have reported this time as
100% full time and 50% IME/GME. MACs may evaluate the files for this type of error on their IRIS diskette/CD
copies, and they may request providers to submit revised IRIS diskettes/CDs at any time in the future.
(c) Certification Date. Providers have entered certificate issuance dates for the foreign student certification date field in
the master file. These dates are usually listed on Educational Commission for Foreign Medical Graduates (ECFMG)
certificates for residents that have successfully passed its examinations. These certificates also contain dates for
medical and English examinations. The medical examination consists of basic science and clinical science
examinations, and the latest date for passing these examinations is the date for data entry into the certification date
field in the master file. The result of this error is the certification issuance date is usually several months or more after
the latest date of the science examinations. MACs may evaluate the files for this type of error on their IRIS
diskette/CD copies, and they may request providers to submit revised IRIS diskettes/CDs at any time in the future.

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(d) Graduation Date. Providers have used the medical school graduation date to enter as the same date for the foreign
student certification date. This situation may arise for allopathic or osteopathic residents whose certification date is prior
to their medical school graduation date, or for dental residents that are not required to take ECFMG examinations. These
two dates are used to pass the IRIS system edits. The use of these dates is acceptable as long as the provider
documents the information on certification dates and medical school graduation dates for audit trail purposes. MACs may
evaluate the files for this type of error on their IRIS diskette/CD copies, and they may request providers to submit revised
IRIS diskettes/CDs at any time in the future.
8. Modification of Data on IRIS Diskettes/CDs
We discovered that EXCEL 2007/2010/2013 can import dBASE data but it will not export spreadsheet data to a dBASE
file (earlier versions of EXCEL can export spreadsheet data to a dBASE file). However, individuals using EXCEL
2007/2010 for creating and modifying data in the master and assignment files may use ACCESS 2007/2010 for exporting
spreadsheet data to a dBASE file format (*.dbf). The procedures for exporting such data to a dBASE file are as follows:
(a) Modify the data in the IRIS data files (master and assignment) files in EXCEL 2007/2010; save these files in the
default file format (*.xlsx).
(b) Open ACCESS 2007/2010 and perform the following steps for each IRIS file:
Click on the Office button or File tab in the upper left hand corner, click on Open, click on “All Files (*.*)” in “Files of
type” at the bottom of the screen, point to the master or assignment file in Excel format, and click on Open.
The Link Spreadsheet Wizard screen appears. Make sure the radio button is set for “Show Worksheets, and click on
the Next button at the bottom of the screen.
The Wizard screen appears again. Make sure a check appears besides the “First Row Contains Column Headings”,
and click on the Next button at the bottom of the screen.
The Wizard screen appears again with a linked table name. Click on the Finish button at the bottom of the screen,
and a finished message appears. Click on the OK button.
The ACCESS Home Page appears with the table (EXCEL file format) in the left column. Click on the table name with
the master or assignment file data to view the table contents. If the contents appear okay, then click on the Office
Button in the upper left hand corner and click on Save. Then click on the External Data Tab at the top of the screen.
In the Export area of the screen, click on the export table file symbol with the inverted triangle in the lower right hand
side of this area. Then click on dBASE File. The Export - dBASE file screen appears with the destination file name
and format (usually dBASE III). If this information is acceptable, then click on the OK button at the bottom of the
screen.
The Export - dBASE file screen with the Save Export Steps heading appears with a message for saving export steps.
You do not have to click on the blank square for saving export steps. Click on the Close button.
Then click on the Office Button in the upper left hand corner, click on Open, click on “All Files (*.*)” in “Files of type” at
the bottom of the screen, point to the master or assignment file in dBASE format, and click on Open.
The ACCESS Home Page appears with the table (dBASE file format) in the left column. Click on the table name with
the master or assignment file data to view the table contents. If the contents appear okay, then click on the Office
Button in the upper left hand corner of this page and click on Save. Exit ACCESS 2007/2010 by clicking on the “x”
button in the top right hand corner of this page.
If necessary, open ACCESS 2007/2010 again and repeat the above steps for the other IRIS data file.
The IRIS data files (dBASE file format) that you created (M3xxxxxx.dbf and A3xxxxxx.dbf where xxxxxx is the provider’s
six-digit Medicare identification number) in your PC hard drive are ready for downloading to an IRIS diskette/CD. MACs