More Medicaid GME Funding Possible For More Texas Teaching Hospitals
By David Doolittle


More Texas teaching hospitals are now eligible to receive federal dollars from the Centers for Medicare & Medicaid Services (CMS) through the Medicaid graduate medical education (GME) program.

Teaching hospitals in Texas that are owned and operated by a governmental entity other than the state, such as a county hospital district, can now request matching funds from CMS. No state funds are used. CMS approved this provision in response to a December request by the Texas Health and Human Services Commission (HHSC).

“Texas is pursuing every available funding option to help make health care in Texas even stronger,” said HHSC Executive Commissioner Courtney N. Phillips, PhD.  “Enhanced funding and solid partnerships with hospitals will take us to the next level in terms of quality care and keeping Texas doctors here.”

The commission estimates this new provision could result in as much as $84.9 million in Medicaid GME payments to the newly eligible hospitals, should they take advantage of this option. The amount each hospital may receive depends on the number of residents it is training and its inpatient Medicaid caseload.

Nine teaching hospitals are affected by this decision, encompassing a large proportion of the state’s residency programs:

  • Harris County Hospital District, Houston;
  • Hunt Regional Medical Center, Greenville;
  • John Peter Smith Hospital, Fort Worth;
  • Medical Center Hospital, Odessa;
  • Midland Memorial Hospital, Midland;
  • Parkland Memorial Hospital, Dallas;
  • University Health System, San Antonio;
  • University Medical Center of El Paso; and
  • University Medical Center of Lubbock.

Until now, only the five state-owned teaching hospitals had been eligible for this type of funding. They receive a combined $30.5 million each year through the intergovernmental transfer and federal match process. 

The commission’s overall plan is to help all of the state’s teaching hospitals access Medicaid GME funds. To accomplish this, this spring HHSC will ask CMS to extend eligibility to Texas’ 59 privately owned teaching hospitals, including 11 children’s hospitals. If approved, an effective date of April 1 is anticipated. The commission estimates this could result in $111 million in Medicaid GME payments in the first year. 

A third HHSC GME effort requires state legislative action. Senate Bill 2238 by Sen. Lois Kolkhorst (R-Brenham) and House Bill 2798 by Rep. Stephanie Klick (R-Fort Worth) would authorize the commission to annually update the state’s Medicaid payments to teaching hospitals to more accurately reflect current costs. These costs have not been updated since 2012. Both bills are pending in committee.

Last Updated On

April 01, 2019

David Doolittle


(512) 370-1385

Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

More stories by David Doolittle