Bipartisan Concern Simmers Over Transparency at CMMI

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Recently, House Committee on Ways & Means Chairman Richard Neal (D-MA) and Ranking Member Kevin Brady (R-TX) expressed concern at what they characterized as a lack of transparency and public input in the Center for Medicare and Medicaid Innovation’s (CMMI) demonstration models. The lawmakers criticized what they see as CMMI’s infrequent use of the formal rulemaking process, instead subjecting only mandatory models to the process and developing non-mandatory models without the formal, transparent process required of most agency-level policy changes.

Letter

In their letter, Chairman Neal and Ranking Member Brady requested that CMS provide a detailed list of the models under active consideration by the agency, saying that stakeholders have alerted them to new models under development. They also asked the agency to describe any activities that CMMI plans to “promote transparency and engage Congress, stakeholders, Medicare beneficiaries, and the public” before finalizing forthcoming models. Chairman Neal and Ranking Member Brady expect CMS to follow Congress’s intent when it created CMMI, writing that they expect it to test and promote innovative delivery system models but not to “bypass Congress and the public to rewrite Medicare law.”

This letter comes after last Congress’ leaders of the Ways and Means Committee weighed in on several proposed regulations from CMS related to burden reduction, including the agency’s overhaul of Medicare’s Accountable Care Organization program.

In that letter, then Committee chair Kevin Brady and Peter Roskam provided feedback on CMS’s recent proposals, praising many of the recent efforts toward reducing regulatory burden on physicians. The Congressional leaders praised CMS’ efforts to reduce unnecessary and overly burdensome reporting measures in the Merit-based Incentive Payment System, revamping the reporting requirements surrounding electronic health records to align with modern technologies and expanding telehealth reimbursement. The congressional leaders also voiced some concerns with other CMS proposals that relate to health IT.

What’s next with CMMI?

As noted, CMMI has been notably quiet in the first two years of the Trump Administration. Adam Boehler, the former CEO of home-based care startup Landmark Health, was named CMMI Director back in April. Many industry stakeholders have been waiting to see what CMMI has in store for this year. Choas Roades offers Boehler and CMMI a laundry list of ideas here, worth a read if you are interested in CMMI’s activities.

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