The Seventh Circuit recently ruled that "pure research time" must be included in a provider's fiscal year 1996 full time equivalent (FTE) resident count for purposes of the Medicare indirect medical education (IME) adjustment. The University of Chicago Medical Center v. Sebelius, 2010 WL 3324896 (7th Cir. 2010). With this ruling, the Seventh Circuit joins the Eastern District of Michigan, the District of Arizona, the District of Rhode Island (reversed by the 1st Circuit) and the Southern District of Ohio in holding that prior to October of 2001, resident time spent in research and other scholarly activities must be included in the IME FTE count. However, while other courts relied on the plain language of the IME regulation, PPACA saved the Seventh Circuit from having to decide whether to issue a decision contrary to the First Circuit's 2008 ruling that resident research time cannot be included in the IME FTE resident count. See Rhode Island Hospital v. Leavitt, 548 F.3d 29 (1st Cir. 2008). Section 5505 of PPACA states that effective January 1, 1983, the IME FTE count includes "all the time spent by an intern or resident in an approved medical residency training program in non-patient care activities, such as didactic conferences and seminars . . . that occurs in the hospital." The court reasoned, "to us, in ordinary parlance, research activities are clearly a subset of non-patient care activities." Noting that the First Circuit "did not have the opportunity to consider Congress's health-care legislation," the court ruled that, based on the "dispositive" legislation, the hospital should have received reimbursement as part of its IME adjustment for pure research in 1996. The Seventh Circuit's application of PPACA to the pre-2001 resident research time issue should serve as useful precedent for providers with pending appeals on this issue.