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Table 1- Medicare Payments to Hospitals and/or Ambulatory Sites, Pre and Post BBA of 1997

Medicare Payment Recipient and Bearer of Costs	Training Site (rotations)	DME		IME
		Pre-BBA	Post-BBA	Pre-BBA	Post-BBA
Hospital	Hospital inpatient or hospital-owned outpatient	Yes	Yes	Yes	Yes
	Non-hospital ambulatory entitiy (free standing)	Yes-payment to hospital when it pays resident salaries	Yes-payment to hospital when it bears all or substantially all training costs	No-payment was not an option under federal statute	Yes-payment to hospital when it bears all or substantially all training costs
Ambulatory: Federally Qualified Health Center (FQHC), Rural Health Clinic (RHC) or Medicare + Choice Entitiy	Non-hospital ambulatory entitiy (free standing)	No-payment was not an option under federal statute	Yes-payment to ambulatory site when it bears all or substantially all training costs	No-payment was not an option under federal statute	No-no payment to ambulatoy site, even when it bears all or substantially all training costs

All hospital outpatient facilities affiliated with a hospital are paid by hospital inpatient rules.
Free standing means not hospital owned or operated.

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