Posted on Monday, February 17, 2020 2:46 PM
Key members of two House committees that oversee Medicare and Medicaid have introduced legislation to increase oversight and accountability of the Centers for Medicare & Medicaid Innovation (CMMI).
CMMI is the division of CMS that has the authority to test innovative model health care payment models with the goal of reducing spending and improving the quality of care. CMMI has come under fire from members of Congress over recent years for initiating “politically-driven or other policy changes…that could be harmful to patients and providers.” CMMI’s recent models of interest to home health and hospice are the Direct Contracting Model Options, the Primary Care First Model Options and a Value-Based Insurance Design Model (VBID)under which participating Medicare Advantage plans could offer hospice as part of the benefit package.
According to NAHC, the legislation will:
- Require the Secretary of Health and Human Services to develop and implement a plan to monitor the effect of a model on applicable individuals, and mitigate any adverse impact, including reductions in care or reduced access to care and ensures the plan assesses and tracks the impact of delivery and payment models on health disparities
- Require the Secretary to mitigate any adverse impact that he or she determines could affect health care outcomes
- Create an expedited Congressional disapproval process for models
- Create a new process for public input, including advance public notice and an opportunity for stakeholder input and public comments regarding the establishment, testing, implementation, evaluation, and expansion of a health care delivery model
- Require CMMI to consult representatives of relevant federal agencies, clinical and analytical experts with expertise in medicine and health care management, specifically those with expertise in:
- The health care needs of minority, rural and underserved populations, and
- The financial needs of safety net, community based, rural and critical access providers, including federally qualified health centers
- Provide for hardship exemptions in the case that requirements by CMMI result in undue economic hardship for a provider or supplier, or loss of access to such provider for vulnerable populations
Source: NAHC
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