What to Know
- Teaching hospitals operating at or above their current FTE caps can apply for additional resident slots through three new Section 5506 redistribution rounds.
- CMS will evaluate each applicant based on hospital characteristics, how the hospital plans to use the additional cap space, and its commitment to high-quality training.
- Applications are due in October, so time is of the essence.
The Centers for Medicare & Medicaid Services (CMS) recently announced multiple rounds of resident cap slot redistribution under Section 5506 of the Patient Protection and Affordable Care Act. Teaching hospitals can apply for the slots from the three hospitals (in Illinois, Ohio, and Minnesota) to gain cap slots if their hospital is training at or above their existing FTE caps.
This time-limited opportunity is one of the few ways hospitals can increase FTE caps and, therefore, Medicare reimbursement to support and sustain their graduate medical education (GME) training programs.
Application Selection Criteria and Submission Deadlines
The application requires hospitals to outline the intended use for cap space, demonstrate a commitment to high-quality training, and provide supporting documentation. Applications are reviewed by CMS and ranked based on a number of characteristics, including:
- Whether the applicant (i.e., hospital) has assumed the training of residents from the closed hospital.
- Geographic information (e.g., proximity to the closed hospital, location in a HPSA).
- Ability to fill the slots within three years.
- Expansion of prioritized programs (e.g., primary care, general surgery, geriatrics).
Applications are now open and are due on October 13, 2026 (Round 29) and on October 29, 2026 (Rounds 30 and 31). The table below outlines the indirect medical education (IME) and direct GME cap slots that are currently up for redistribution.
| Round 29 | Round 30 | Round 31 | |
|---|---|---|---|
| Closed Hospital |
Louis A. Weiss Memorial Hospital (CCN 140082) |
Insight Hospital and Medical Center Trumbull (CCN 360055) |
M Health Fairview St. Joseph’s Hospital (CCN 240063) |
| Location (CBSA) | Chicago, IL (16984) | Warren, OH (49660) | Saint Paul, MN (33460) |
| IME FTEs | 85.82 | 75.11 | 13.36 |
| Direct GME FTEs | 66.79 | 76.93 | 13.38 |
| Application Due Date | 10/13/26 | 10/29/26 | 10/29/26 |
Source: Federal Register, Centers for Medicare & Medicaid Services on July 7 and August 4, 2026.
More information about historical trends in cap slot redistribution can be found in a previous ECG blog post.
Application and Support
Cap redistribution is infrequent, and the due dates for the three applications are rapidly approaching. The online applications may be found on MEARIS and must be submitted digitally.
We recommend that GME leaders monitor the CMS website and Federal Register for notifications of subsequent rounds to ensure their teaching hospitals are well positioned to secure additional cap slots in the future.
ECG has helped teaching hospitals apply for and gain additional cap space in prior rounds.
Contact our team for more information on how to approach the application process and position your hospital as a strong candidate.
