Global Health Nexus, Winter 2004

Update on GME Funding Battle: A Bittersweet Victory

It was a close call, but sometimes right does triumph over might. In response to two and a half months of aggressive lobbying by dental educators, students, faculty, staff, organized dentistry, and political allies, the Centers for Medicare and Medicaid Services (CMS) eliminated a proposed rule that would have effectively nullified the dental Graduate Medical Education (GME) program, a tool used by the federal government to subsidize medical education so that residents can be paid a small stipend and usually also get free tuition and health benefits.

While success was achieved at the national level by several key lobbying groups brilliantly orchestrated by the American Dental Education Association (ADEA), NYU Dentistry played a significant role through its amazing letter-writing campaign. Indeed, when Dean Alfano was selected by ADEA to meet with CMS officials in Maryland to argue our case, a young CMS attorney begged him to stop the huge influx of letters from NYU, which was overwhelming the CMS staff.

Had the ruling stood, it would have removed millions of dollars in federal GME funds from 40 dental schools retroactively! The consequences for NYU Dentistry would have included a drastic reduction in the number of available residency slots, cuts in programs and services for both students and patients, budget deficits, and large layoffs.

Ultimately, CMS agreed to eliminate the retroactive aspects of the proposed rule and to honor commitments to dental residents who entered residency programs on or before October 1, 2003, through the end of their residencies or for three years, whichever comes first. As a result, budget deficits at NYU Dentistry were eliminated and disastrous consequences avoided. However, in October 2006, the GME program will formally end, and the intent of Congress in establishing dental GME through the Balanced Budget Act of 1997 — to encourage and support the expansion of dental residency training programs in nonhospital locations — will be voided.