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Program Data

National Per Resident Amount (NPRA)

Overview (March 1, 2012)

The Children’s Hospital Graduate Medical Education (CHGME) Payment Program mandates the utilization of a national per resident amount (NPRA) to compute the Program’s direct graduate medical education (DME) payments (Public Law 106-129).  As mandated in Section 340(F) of the 1999 Public Health Service Act, the Secretary is required to update the NPRA annually (Public Law 106-129). As delineated in the June 19, 2000 Federal Register Notice in accordance with Section 1886(h)(4) of the Social Security Act, the Secretary determines and computes the standardized national per resident amounts for each children’s hospital that is adjusted for wages (Federal Register, June 19, 2000). In March 2001, the CHGME Payment Program published and finalized the NPRA for cost reporting periods ending in 1997 (Federal Register, March 2001).  The 1997 estimate of the NPRA was $67,688.

The amended statute, Section 340E(c)(2) of the 1999 Public Health Service Act, specifies that this baseline amount should be updated annually using the estimated percentage increase in the consumer price index (CPI) for all urban consumers during the period beginning October 1997 and ending with the midpoint of the Federal fiscal year for which payments are made (Public Law 106-129). The updated amount will be posted on the CHGME Payment Program Website. The following table provides the baseline estimated NPRA and the yearly updates from 2001 through 2009. The updated figure is determined by applying the percent increase in CPI from October 1997 through March 2010 to the baseline NPRA from FFY 1997.  Methodology and specific computations are also included.