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House lawmakers introduce bill to tighten CMMI's reins

6 Feb 2020 5:38 PM | Matt Zavadsky (Administrator)

Commentary: Interesting news, especially in light of the revolutionary new ET3 model CMMI is rolling out for ambulance services…


House lawmakers introduce bill to tighten CMMI's reins


February 04, 2020


A bipartisan group of House lawmakers on Monday introduced a bill to ramp up transparency and accountability efforts for the CMS' Center for Medicare and Medicaid Innovation.

The Strengthening Innovation in Medicare and Medicaid Act—HR 5741—would require the HHS secretary to keep track of how a demonstration model affects beneficiaries' access to care. HHS would also have to monitor the effects of delivery and payment changes on healthcare disparities and alleviate related issues that could negatively affect health outcomes.

The bill aims to boost transparency by creating an expedited process for Congress to reject models and makes it easier for the public to comment on proposed models and changes.

The Innovation Center, also known as CMMI, would also have to consult with experts on the healthcare needs of minorities, rural and underserved populations, and the financial demands of safety-net and rural providers.

Providers and suppliers could seek hardship exemptions from the Innovation Center if they would be subject to undue economic hardship or if the agency's requirements caused vulnerable populations to lose access to specific providers.

Reps. Terri Sewell (D-Ala.), Adrian Smith (R-Neb.), Tony Cárdenas (D-Calif.) and John Shimkus (R-Ill.) introduced the legislation.

"It is essential that Congress ensures that CMMI functions as intended, to improve the quality and efficiency of care delivered, and incorporates greater opportunity for public input," Sewell said. "The legislation we introduced today would safeguard the center from implementing politically driven or other policy changes made unilaterally by any administration that could be harmful to patients and providers."

Lawmakers, especially those who represent rural or underserved populations, have expressed concern that the Innovation Center has too much discretion to design, test and implement new payment models without adequately considering their effects on healthcare delivery outcomes.

"This bill would reduce uncertainty throughout the healthcare marketplace by providing for appropriate oversight of CMMI," Smith said.

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