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The policies and procedures established in this document are intended to provide a governance structure for overseeing the graduate medical education programs by Barnes-Jewish Hospital, St. Louis Children's Hospital and Washington University School of Medicine, hereafter known as "the institutions."  These policies will be ratified by the governing bodies of each institution and will serve as the policies for oversight of graduate medical education by each institution unless specific delegatory authority to specific institiutions is granted in these policies.  Nothing in this document is intended to, nor should it be construed as placing within the Consortium's scope of responsibility and authority, the ability to determine how any party will bill for services provided by individuals who participate in the GME Program, including, but not limited to, billing for services provided under the Medicaid Program, or the Medicare Program, or to impact the reporting of associated costs by any party to Medicare.  Effective as of December 3, 1997, the parties mutually agree to operate graduate medical education programs in accordance with the principles outlined on this website.