House GOP tells CMS to stop mandatory involvement in payment reform proposal
House Republicans want the CMS to stop rolling out new mandatory payment models they say threaten quality of care and overstep the agency’s authority.
In a letter to acting CMS Administrator Andy Slavitt and Chief Medical Officer Dr. Patrick Conway, the 179 members of the House say the Center for Medicare and Medicaid Innovation has “exceeded its authority” and “patients are blindly being forced into high-risk government-dictated reforms with unknown impacts.”
The letter targets two bundled-payment models—the Comprehensive Care Joint Replacement Model and the Cardiac Bundled Payment Model.
They also cite the Part B Drug Payment Model, which changes the way doctors are reimbursed for outpatient drugs.
Lawmakers and provider groups say more time is needed to review the proposals.
In a statement last week, the CEO of the Medical Group Management Association said the group wants more alternative payment models but agrees with the GOP lawmakers.
“Instead of a purely top-down government approach, CMMI should also adopt proven private-sector initiatives that advance Medicare’s goal to provide high-quality, cost-effective patient care,” Dr. Halee Fischer-Wright wrote.
The congressional letter is spearheaded by Reps. Tom Price of Georgia, Charles Boustany of Louisiana and Erik Paulsen of Minnesota. One Democrat, Rep. Brad Ashford of Nebraska, also signed it.
Bundled payments involve setting one price per patient per episode of care and are one of the more popular options in the growing movement toward value-based payment in healthcare. Studies have shown mixed results, but some have had success in reducing costs and improving patient outcomes.