Healthcare Leadership Council Endorses Legislation to Erect Patient Safeguards in Medicare, Medicaid Innovation Projects

Bipartisan Measure Will Institute Transparency, Accountability Mechanisms

WASHINGTON – The president of the Healthcare Leadership Council (HLC) said today that bipartisan legislation introduced in the U.S. House of Representatives will maintain the Center for Medicare and Medicaid Innovation (CMMI) as a valuable testing ground for new healthcare payment and delivery concepts while creating essential protections for patients and healthcare providers affected by CMMI demonstration projects.

HLC endorsed the “Strengthening Innovation in Medicare and Medicaid Act”, (H.R. 5741) introduced today by leading sponsors Terri Sewell (D-AL), Adrian Smith (R-NE) and introductory sponsors Tony Cardenas (D-CA), John Shimkus (R-IL), Kurt Schrader (D-OR), and Brad Wenstrup (R-OH).  The legislation would place new limitations on the scope and duration of CMMI model testing.  Demonstration projects would continue for no more than five years and include only the number of beneficiaries necessary to have a statistically valid and reliable sampling of data.

“We value CMMI as a vital mechanism to continue bringing greater value to healthcare delivery,” said HLC President Mary R. Grealy.  “But testing must be temporary, not permanent. And demonstration projects are not meant to have the kind of nationwide impact that would make them, in essence, a wholesale change in Medicare or Medicaid policy.  This legislation maintains important testing while protecting patients and healthcare providers from sustained harm if a new model has unforeseen and adverse impacts.”

The bill also directs the Secretary of Health and Human Services to develop a plan for continuous, real-time monitoring of CMMI model testing in order to protect against reductions in care or reduced access to care.  The bill orders the creation of processes for stakeholder input and public comment on projects and enables judicial review of CMMI decisionmaking as a means to protect Medicare and Medicaid beneficiaries of affected programs.

“We applaud Representatives Sewell and Smith for developing legislation that serves several important purposes,” said Ms. Grealy.  “It promotes responsible testing of new payment and delivery innovations that can bring greater value to our healthcare system.  It underscores that Congress, not the regulatory agencies, is the body that establishes Medicare and Medicaid policy.  And it institutes common-sense safeguards to protect patient access to care and the quality of care.  In the end, this makes CMMI a stronger mechanism for improving healthcare.”