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D.C. Report: Congress Angry Over CMS Innovation Center

June 19, 2012
by Jeff Smith, Assistant Director of Advocacy at CHIME
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Congressional Ire Grows Over CMS Innovation Center The six-month battle cry for information about what the CMS Innovation is doing with its billion-dollar-a-year allowance grew louder this week.  In a letter to HHS Secretary Kathleen Sebelius, Louisiana Republican Representative Charles Boustany Jr. said there needs to be more congressional oversight of grants and projects run by the CMS Innovation Center, also known was CMMI.  “The cost and opaqueness of CMMI requires thorough congressional oversight,” Boustany wrote. “There may be reasons for funding projects that promise a negative return on investments, but taxpayers deserve a public accounting for this use of their hard-earned dollars.”  The letter comes after a Wall Street Journal Op-Ed called a $123 million grant program, known as the Health Care Innovation Challenge, “one more pork program” and agues, “Congress ought to dismantle and defund the program if CMMI survives the Supreme Court ruling on the Affordable Care Act.”  Rep. Boustany requests that HHS Secretary Sebelius provide copies of all Health Care Innovation Challenge applications, a list of application reviewers and name and title of all CMMI officials who chose each award winner by the end of this month.

This is only the latest instance of congressional scrutiny against the CMS Innovation Center, which has $10 billion over 10 years to develop and implement programs that test ways to transition healthcare delivery and financing away from the current fee-for-service payment model to one that is predicated on performance.  Previously, Republican Senators and House Ways & Means leadership have sent similar letters to HHS and the Governmental Accountability Office.

Representative Wants EHR Safety Roadmap In November 2011, the Institute of Medicine (IOM) issued a report calling on HHS to develop a plan within 12 months to minimize patient safety risks associated with health IT and report annually on the progress being made.  And this week North Carolina Republican Renee Ellmers asked HHS Secretary Sebelius for a status update.  In a letter to HHS Secretary Sebelius (her mailbox saw some action this week) Rep. Ellmers requested the Secretary’s plan and associated schedule for working with the private sector, to deliver on the IOM-recommended report.  Rep. Ellmers is also asking for list of the “number, type, description, location and origin of any and all health IT-related errors involving medication dosing, failure to detect fatal illness and treatment delays due to human-computer interactions,” in addition to a handful of other pieces of information.  The letter asks for a complete update by July 13.

CMS Announces Another Round of Advance Payment ACOs; Announces 81 Healthcare Innovation Awards  CMS announced that another round of Advanced Payment ACOs will begin Jan. 1, 2013.  The special Advance Payment ACO Model differs from regular ACOs in that it offers advanced payments to rural and physician-based ACOs under the Shared Savings Program to build the infrastructure necessary to coordinate care for their patients. Regular ACOs share the cost savings by coordinating care (reducing duplicate tests, rehospitalizations, and more) for the Medicare Program.  Originally, this program only had two rounds beginning on April 1, 2012 and July 1, 2012. Only five Advanced Payment ACOs began in April. The deadline to apply to the Medicare Shared Savings Program is June 29, 2012. Applications for the Advance Payment Model will be accepted from July 1, 2012 until Sept. 19, 2012. For more information, visit the CMS website for Advance Payment ACOs.

Recently, 81 Healthcare Innovation Awards were announced by CMS for projects with goals of recognizing sepsis early (initiative in Texas), restructuring emergency medical services to reduce unnecessary hospitalizations (Nevada), and other initiatives that will lower costs, better prepare the healthcare workforce, and improve patient care. CMS distributes these awards over three years.

CMS Gets Half Billion Dollar Boost by Senate AppropriatorsThe Senate Appropriations Committee approved funding for Centers for Medicare and Medicaid Services operations in fiscal 2013 by $547 million, an increase that would help implement the health care overhaul.  The vote passed 16-14 on Thursday, but the increase is just more than half the $1 billion that President Obama had requested.  Winners in the Senate bill include the National Institutes of Health ($100 million increase from last year) the Centers for Disease Control and Prevention ($30 million more).  The bill also provides $3.067 billion for community health centers, an increase of $300 million. And it includes $265 million for children’s hospital graduate medical education.