The Centers for Medicare & Medicaid Services has released a list of hospitals that applied for additional residency slots under Section 422 of the Medicare Modernization Act, and the number of direct and indirect graduate medical education slots awarded to the hospital effective July 1, 2005. Section 422 allowed teaching hospitals to request up to an additional 25 full time equivalent residents from the estimated pool of unused slots for purposes of direct and indirect GME payments under Medicare. By law, CMS must distribute the unused slots first to rural hospitals, second to urban hospitals not located in large urban areas, and third to hospitals training residents in a program that is the only program in the state. CMS on Oct. 27 mailed letters to each hospital notifying them of their final award determinations.