IRIS & IRIS Proxy. Children’s Hospitals Graduate Medical Education Payment Program. Agenda. IRIS IRIS Proxy Updates IRIS Common Errors IRIS EDV3 Edit Program Q & A Session. IRIS. I ntern and R esident I nformation S ystem. IRIS Recap. Who can use the IRIS?
Graduate Medical Education
IRIS Proxy Updates
IRIS Common Errors
IRIS EDV3 Edit Program
Q & A Session
Intern and Resident Information System
Who can use the IRIS?
Full Filing Providers
DOS based program (CMS)
Does NOT compute the FTE count of interns/residents
Master File (M3XXXXXX.dbf)
Contains pertinent information about the interns/residents
Assignment File (A3XXXXXX.dbf)
Contains the rotational assignment data for those interns/residents
Some text fields report Numbers. Microsoft Excel XP will try to identify this as an error.
Residency Code Table in Alphabetic Sequence
Part II, Section 7.4
Part II, Section 7.2
Part II, Section 7.3
Part II, Section 7.5
Refer to Table of Residency Codes (page 7-17).
Add additional name to the Employer Name Table
Add, Modify, or Delete
<5> Reference Files/Data Management
<2> IRIS Reference Data Management Menu
Residency Years Completed
Range for Total Number of Program Years
Medical School Code
“99998” – Foreign Dental School
“99999” – Foreign Medical School
Dental School Codes
10000 & 20000 – Obsolete
Use New Codes 80002-80109
Assignment Time Periods
Added Non-Hospital Reference
42 CFR 413.78(e)
Periods that Span July 1
Enter as 2 periods on IRIS
Fiscal Year : 10/01/04 – 09/30/05
Rotation: 05/01/05 – 11/30/05
05/01/05 - 06/30/05
07/01/05 - 09/30/05
New Dental School Codes
For cost reporting periods BEGINNING on or after July 1, 2006AND
Interns & Residents (I&Rs) in dental specialties with dental school Graduation Dates after April 30, 2006
New Residency Type Codes
Highlighted in YELLOW
Since the IRIS report is submitted with the MCR, the signature on the MCR is all that is needed (W/S S, Part I).
All rotation schedules or additional certification is not necessary for IRIS verification.
Who can use the IRIS Proxy?
No/Low Utilization Providers who are not required by CMS to submit an IRIS with their Medicare Cost Report
Computes the FTE resident count
Available at no charge to hospitals
Calculates Total GME Unweighted and Weighted Resident FTE counts by:
Each Intern/Resident Rotation
Total Allopathic and Osteopathic Residents
Total Allopathic and Osteopathic in Initial Residency Period
Total Dental and Podiatric Residents
Total Dental and Podiatric Residents in Initial Residency Period
Option to create IRIS Master and Assignment data files
Located in upper right corner of the worksheet
Summary Totals do NOT account for any duplicate assignment periods (overlaps).
Update: Summary Totals Report
Totals Report identifies Unweighted and Weighted resident FTE summary by specialty.
After viewing Totals Report, click “CHGME” tab at the bottom of the screen to return to original listing.
Totals Report FTE Count =
Allopathic/Osteopathic FTEs + Dental/Podiatric FTEs
IRIS Proxy Edits
The following input errors will result in the FTE being reduced to zero:
Listed as a international/foreign medical school graduate but NOIMG/FMG Complete Date is entered
A Graduation Date is NOT entered or date is NOTPRIOR to first rotational begin date
Rotational Assignment Dates begin or end OUTSIDE of the fiscal year
Highly recommended that the IRIS data be validated by a separate IRIS/GME edit program
CMS IRIS FI Edit Program (IRISEDV3)
Same software used by Full Filing hospitals and all FIs
Third-Party Vendor GME Software
Data that does not pass CHGME FI edits may be returned to the hospital for rework.
New/Revised Program Codes
Medical School Codes
Revised 6 of 8 Podiatry Schools
Codes 30100 – 30600
New Dental School Codes
United States, Canada, Puerto Rico
Codes 80002 – 80109
Codes 30010 – 30090 for Podiatry Schools
Codes 10000 and 20000 for all Dental Schools
Refer to Table of Medical Schools (page 7-10).
Medical School Codes (continued)
30010 – Barry University School of Podiatric Medicine (Miami Shores, FL)
New Code - 30500
30020 – William M. Scholl College (Chicago, IL)
New Code – 30100
30040 – College of Podiatric Medicine (Des Moines, IA)
New Code - 30600
30050 – New York College of Podiatric Medicine (New York, NY)
New Code - 30200
30080 – Ohio College of Podiatric Medicine (Cleveland, OH)
New Code - 30300
30090 – Temple University School of Podiatric Medicine (Philadelphia, PA)
New Code - 30400
Current Version updated 2009
Addition of New Programs and Medical School Codes
Updated Formatting Errors
Do not use nicknames or abbreviations!
Institution currently paying the resident’s salary
Residency Type Code
Initial Specialty Program
Specialty initially chosen by resident during the first year of post graduate training program
Medical School Graduation Date
If the specific graduation date cannot be determined, but the graduation month is known, use the first day of the known month
Assignment Beginning and Ending Date
Resident’s start and end dates for EACH rotational assignment during which the intern/resident was assigned to and worked at the hospital complex or any of its hospital based providers.
Follow original source documentation
Rotation schedules, calendars, etc.
Percentage of time intern/resident worked in the hospital in comparison to the total time worked at all facilities (Resident’s Total GME must equal 100%) .
If in a non-hospital setting must have a written agreement.
Hospitals must coordinate GME data reported in IRIS
IME % does NOT apply to Children’s hospitals. Enter the same % as the GME % or enter zero(0).
Initial Residency Period
Prior to 10/01/04
Determined as of the time the resident enters the “initial” or first residency training program
Based on the period of board eligibility associated with the program in which a resident participates in the first year of training, without regard to specialty in which the resident ultimately seeks board certification
69 FR 49170 (August 11, 2004)
FY 2005 DRG Rates for Hospital Inpatient PPS
For purposes of direct GME, a national process by which applicants to approved medical residency programs are paired with programs on the basis of preferences expressed by both the applicants and the program directors
Effective for portions of cost reporting periods beginning on or after 10/01/04
If hospital documents….
Resident matched in an advanced specialty program that requires clinical base year prior to resident’s first training year
IRP is determined based upon period of board eligibility associated with second year specialty program
70 FR 47449 (August 12, 2005)
Inpatient Hospital PPS for 2006
To claim specialty program as IRP..
Hospital must document that a resident matched PRIOR to beginning any residency training in an advanced residency training program beginning in the second residency year
National Residency Matching Program (NRMP)
San Francisco Matching Program
Urology Matching Program
American Osteopathic Association Residency Match Program
The total number of years the intern/resident has completed in ALL types of approved residency programs
Based on the number of years completed as of FIRST DAY of reported rotational assignment
This includes CLINICAL BASE year or transitional year for “Matched Residents”
Document, Document, Document!!!
What is the IRISEDV3?
A program used to run edit checks on the Intern and Resident Information System (IRIS) diskette
Available at no charge to hospitals
Provides all major edit checks that will be done by your CHGME FI
Setup of the IRISEDV3
Obtain all necessary files:
Program should be on computer’s hard drive
This is a MUST:
Read the installation instructions (Readme.doc) BEFORE beginning installation!
First Time Use
The FIRST time the program is opened, complete “Data Management” from Main Menu
First Time Use (cont.)
Setup Administrative Data
Rebuild Data Indexes
Be sure to save (“S”) set-up and exit (“X”)
During Step <2> Rebuilding Data Indexes – Screen may flicker. This is okay!
<1> Capture IRIS Data Submitted
Ensure diskette with IRIS files (M3XXXXXX.dbf and A3XXXXXX.dbf) is in the disk drive (usually “A”).
Verify provider number is correct.
<2> Import Captured Provider Data into Test Shells
Automatically completed by program
<3> Evaluate and Edit Imported Provider Data
Provides on-screen EDITS during processing
Assignment End Date is after FY End Date (12/31/2004)
<4> Print Report of Evaluation and Edit
It is optional to print reports
Default = <2> Print All Records
Part I – New Records that Passed all IRIS Edits
Part II – Records that Failed One or More IRIS Edits
e.g. Assignment date outside fiscal year
Part III – Invalid Records
e.g. Assignment record with invalid or blank fiscal year begin date
Part III may also include any duplicate records in the Master File
IRISEDV3 cannot be used to change data. It is only capable of edit checks.
IRISEDV3 does not check for zero values or blanks in the Full Time/ Part Time Percentage (%) and GME Percentages (%) fields of the IRIS files.
IRISEDV3 will greatly improve your chances of submitting a good IRIS/IRIS Proxy, but it will not guarantee complete success.
The CHGME FI may determine that an IRIS/IRIS Proxy diskette is still incorrect even though it cleared IRISEDV3 edits.
Full Time/Part Time Percentage (%) was entered as the portion of the year the intern/resident was at a hospital instead of the type of residency slot he/she filled.