Hospital Medical Education Payments
In addition to the regular Medicaid per diem payments, in-state hospitals that qualify as teaching hospitals may be eligible for a medical education supplemental payment.
Direct Medical Education (DME)
In order to qualify as a teaching hospital and be deemed eligible for DME supplemental incentive payment adjustments, the hospital must:
- be licensed by the State of Oklahoma;
- have costs associated with approved or certified Oklahoma medical residency programs in medicine, osteopathic medicine, and associated specialties and sub-specialties. An approved medical residency program is one approved by the Accrediting Council for Graduate Medical Education of the American Medical Association, by the Bureau of Professional Education of the American Osteopathic Association, or other professional accrediting associations. A resident is defined as a Post-Graduate Year 1 (PGY1) and above resident who participates through hospital or hospital-based rotations in approved medical residency/internship programs in Family Medicine, Internal Medicine, Pediatrics, Surgery, Ophthalmology, Psychiatry, Obstetrics/Gynecology, Anesthesiology, Osteopathic medicine, or other Certified Medical Residencies, including specialties and sub-specialties as required in order to become certified by the appropriate board; and
- apply for certification by the OHCA prior to receiving payments for any quarter during a State Fiscal year. To qualify, a hospital must have a contract with the Oklahoma Health Care Authority (OHCA) to provide Medicaid services and belong to The Council on Teaching Hospitals or otherwise show proof of affiliation with an approved Medical Education Program. Affiliation means an agreement to support the costs of medical residency education in the approved programs. In addition to the Federal and state hospitals, including Veteran’s Administration, Indian Health Service/Tribal and Department of Mental Health Hospitals are not eligible for supplemental DME payments. Major teaching hospitals as defined eligible.
Indirect Medical Education (IME)
In order to qualify as a major teaching hospital and be deemed eligible for an IME adjustment, the hospital or hospitals of common ownership must:
- belong to the Council on Teaching Hospitals or have a medical school affiliation; and
- be licensed by the State of Oklahoma; and
- have 150 or more full-time equivalent (FTE) residents enrolled in approved teaching programs.
Eligibility for an IME adjustment will be determined by the OHCA, using the provider's most recently received annual cost report or the application.