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July 18, 2022

Interns and Residents Information System (IRIS) XML Format

Teaching hospitals are required to submit Intern and Resident Information System (IRIS) data for all interns and residents claimed on the submitted cost report. The federal register for fiscal year 2022 updated 42 CFR 413.24(f)(5)(i)(A) for the following requirements:

  • Cost reports with fiscal year beginning on or after October 1, 2021, must file their IRIS files in the XML format.
  • IRIS files in the XML format may be submitted for cost reports with a fiscal year beginning prior to October 1, 2021, as long as they pass all IRIS edits.
  • The total of graduate medical education (GME) and indirect medical education (IME) full time equivalents (FTEs) reported on IRIS and the as-filed cost report must match for the as-filed cost report to be acceptable.

Approved XML IRIS Vendors

Providers should choose from the following vendors for approved IRIS software. Providers are not required to use vendors from the list, but the vendors listed have been confirmed to be able to produce XML IRIS files that conform to the new format and specification.

  • Besler – iRotations
  • Health Financial System – HFSSoft IRIS
  • MyEvaluations.com – MyGME
  • New Innovations

Medicare cost report worksheets and line references for the total unweighted GME and IME FTEs.

Total Unweighted GME FTEs – IPPS Teaching Providers

  • Worksheet E-4 Line 6: Unweighted resident FTE count for allopathic and osteopathic programs for the current year.
  • Worksheet E-4 Line 10.01, Column 2: Unweighted dental and podiatric resident FTE count for the current year.
  • Worksheet E-4 Line 15.01 Columns 1 & 2: Unweighted adjustment for residents in initial years of new programs.
  • Worksheet E-4 Line 16.01 Columns 1 & 2: Unweighted adjustment for residents displayed by program or hospital closure.

Total Unweighted IME FTEs

  • Worksheet E Part A line 10: FTE count for allopathic and osteopathic programs in the current year from your records.
  • Worksheet E Part A line 11: FTE count for residents in dental and podiatric programs.
  • Worksheet E Part A line 16: Adjustment for residents in initial years of the program.
  • Worksheet E Part A line 17: Adjustment for residents displaced by program or hospital closure.
  • Worksheet E-3 Part II line 6 (Inpatient Psychiatry Facility): Current year’s unweighted FTE count of I&R excluding FTEs in the new program growth period of a “new teaching program”.
  • Worksheet E-3 Part II line 7 (Inpatient Psychiatry Facility): Current year’s unweighted I&R FTE count for residents within the new program growth period of a “new teaching program”.
  • Worksheet E-3 Part III line 7 (Inpatient Rehabilitation Facility): Current year’s unweighted FTE count of I&R excluding FTEs in the new program growth period of a “new teaching program”.
  • Worksheet E-3 Part III line 8 (Inpatient Rehabilitation Facility): Current year’s unweighted I&R FTE count for residents within the new program growth period of a “new teaching program”.

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