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The Cap Flex Act Introduced in Congress


March 4, 2020: Today, The Physician Shortage Cap Flex Act of 2020 ("The Cap Flex Act") was introduced in both the U.S. House of Representatives (HR 6090) and U.S. Senate (S 3390).


A great big thanks and recognition for Dr. Raul Ruiz (CA-36-D) and Dr. John Barrasso (WY-R) for leading the charge in the House and Senate.

Additionally, special thanks goes to Senator Catherine Cortez-Masto (NV), Dr. Larry Bucshon (IN-08), Representative Terri Sewell (AL-7), and Dr. Brad Wenstrup (OH-2) for joining on the bills as original cosponsors.

This important piece of bipartisan bicameral legislation is aimed at addressing our nation's current and looming physician shortage issues by providing teaching hospitals additional time to establish Medicare Graduate Medical Education (GME) caps if they establish residency training programs in primary care or specialties facing shortages.





While well-intentioned at the time, the 1997 caps enacted by Congress on Medicare funded GME slots for existing teaching hospitals has all but crippled the development of GME programs in under-resourced areas and has significantly contributed to the projected physician shortages of today. The substantial amount of resources, investment, and time required to establish new GME programs is a major barrier to their creation. Accomplishing the requisite groundwork for residency programs is all the more challenging for new teaching hospitals, especially those in medically and economically underserved and/or rural areas where available resources are scarcer and the referral area and community need larger.


However, the Centers for Medicare & Medicaid Services (CMS) has both the opportunity and the obligation to leverage its existing authority granted by Congress to establish GME caps in order to strategically target additional support to areas with the greatest need across the country.


Congress has been urging CMS to utilize its existing authority to extend the time frame by which a new teaching hospital's Medicare GME cap is established through bipartisan House and Senate letters, and most recently through language in the FY 2020 Consolidated Appropriations Act. However, despite Congress' efforts, CMS has yet to leverage its authority to institute a more flexible Medicare GME Cap policy.


The Cap Flex Act would mandate that CMS provide new and existing qualifying teaching hospitals with an additional five-year window to establish shortage specialty programs in areas of need across the country.


Learn more: The Cap Flex Act Section-by-Section


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