Distribution of GME Residency Positions Under Section 126 of the Consolidated Appropriations Act (CAA), 2021, and Section 4122 of the CAA, 2023 (CMS-10790)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CMS-10790 Draft MEARIS™ Application screen shots	Form and Instruction	Unchanged	Available
Form CMS-10790 GME-4122 MEARIS Application	Form and Instruction	Unchanged	Repair queued
Form CMS-10790 GME 126 Sample Application	Form and Instruction	Unchanged	Repair queued
Form CMS-10790 Appendix A Proposed Collection Applicant Information for Graduate Medical Education (GME) Section 126	Form and Instruction	Unchanged	Available
Form CMS-10790 GME Applications	Form and Instruction	Unchanged	Repair queued
CMS-10790_Supporting_Statement 8-28-24.docx	Supporting Statement A	Uploaded 2024-08-28	Repair queued
CMS-10790_Supporting_Statement 8-28-24.docx	Supporting Statement A	Uploaded 2024-08-28	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
267329	GME-4122 MEARIS Application	Form and Instruction	Unchanged	Draft MEARIS™ Application screen shots
267329	GME-4122 MEARIS Application	Form and Instruction	Unchanged
251092	GME Applications	Form and Instruction	Unchanged	GME 126 Sample Application
251092	GME Applications	Form and Instruction	Unchanged	Appendix A Proposed Collection Applicant Information for Graduate Medical Education (GME) Section 126
251092	GME Applications	Form and Instruction	Unchanged

ICR Details

OMB Control No: 0938-1417	ICR Reference No: 202408-0938-028
Status: Active	Previous ICR Reference No: 202404-0938-025
Agency/Subagency: HHS/CMS	Agency Tracking No: CM-CPC IPPS
Title: Distribution of GME Residency Positions Under Section 126 of the Consolidated Appropriations Act (CAA), 2021, and Section 4122 of the CAA, 2023 (CMS-10790)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/19/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/29/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2027	36 Months From Approved	03/31/2025
Responses	2,650	0	1,325
Time Burden (Hours)	21,200	0	10,600
Cost Burden (Dollars)	0	0	0

---

Abstract: Section 126 of the Consolidated Appropriations Act (CAA), 2020 (Public Law 116-93), enacted December 20, 2020, included a key provision affecting Medicare payments for Graduate Medical Education (GME). Section 126(a) of the CAA amended section 1886(h) of the Act by adding a new section 1886(h)(9) requiring the distribution of additional residency positions (slots) to qualifying hospitals. Section 1886(h)(9)(A) of the law makes an additional 1,000 Medicare funded residency slots available. Section 1886(h)(9)(B) requires that at least 10 percent of the aggregate number of slots be distributed to hospitals in four categories: (1) hospitals in rural areas (or treated as being located in a rural area under the law), (2) hospitals currently operating over their GME cap, (3) hospitals in states with new medical schools or additional locations, and (4) hospitals that serve areas designated as health professional shortage areas. Additionally, section 1886(h)(9)(C) places certain limitations on the distribution of the residency positions. Eligible teaching hospitals submit applications under this collection for the available slots and CMS staff reviews the applications and supporting documents to determine the validity of the hospitals’ requests for Medicare funded residency slots requested in accordance with Section 126 of the Consolidated Appropriations Act, 2020 (Public Law 116-93) prior to awarding the slots.

---

Authorizing Statute(s): PL: Pub.L. 116 - 260 126 Name of Law: Consolidated Appropriations Act, 2020
  

Citations for New Statutory Requirements: PL: Pub.L. 116 - 260 126 Name of Law: Consolidated Appropriations Act, 2020

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AV34	Final or interim final rulemaking	89 FR 68986	08/28/2024

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
GME Applications	CMS-10790, CMS-10790	Appendix A Proposed Collection Applicant Information for Graduate Medical Education (GME) Section 126 ,   GME 126 Sample Application
GME-4122 MEARIS Application	CMS-10790	Draft MEARIS™ Application screen shots

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	2,650	1,325	0	1,325	0	0
Annual Time Burden (Hours)	21,200	10,600	0	10,600	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The GME section 4122 application collection is a revision to this collection. This is a one-time collection for FY 2026. We anticipate receiving 1,325 applications and supporting documentation and awarding 200 slots in FY 2026 only. The burden hours have increased from 10,600 to 21,200. The cost has increased from $838,460 to $1,104,520.

---

Annual Cost to Federal Government: $1,011,664

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/29/2024

---