On Thursday, two Republican leaders on the House Energy and Commerce Committee sent a letter to HHS Secretary Kathleen Sebelius requesting more information about a federal demonstration program that provides quality bonus payments to Medicare Advantage plans, The Hill's "Healthwatch" reports (Baker , "Healthwatch," The Hill, 8/9).
The Affordable Care Act authorized bonus payments to MA plans that receive a quality score of four stars on a five-star scale. In November 2010, CMS expanded the program to provide bonuses to plans that receive at least three stars.
Demonstration Program a Target of Broad Criticism
Critics of the move have said the $8 billion bonus program amounts to a "slush fund" that would partially offset $145 billion in cuts to the plans over the next decade. Some Republicans also have argued that the program is a political move to win votes in November's election.
In April, a Government Accountability Office report found that the program was unlikely to "produce meaningful results" and advised that it be canceled. The report said most of the bonuses paid went to "average-performing plans" and that researchers were unable to tell whether the increased payments led to improved care (California Healthline, 4/23).
Program 'Masking' Looming Cuts to MA Plans
In their letter to Sebelius, the two Energy and Commerce Committee leaders -- Rep. Fred Upton (R-Mich), the committee's chair, and Rep. Cliff Stearns (R-Fla.), chair of the subcommittee on oversight and investigations -- noted that they requested information about the demonstration program in March, but that it "strains credulity" to believe that what HHS handed over is "fully responsive."
They reiterated that the program "is merely masking the looming Medicare Advantage cuts, and that the program is in serious jeopardy because of the magnitude of [the ACA's] cuts which the government's own actuary estimates will result in the loss of 50% of the enrollment in Medicare Advantage" (Baker , "Healthwatch," The Hill, 8/9).
House Republicans Seek Audit of CCIIO
Also on Thursday, three House Republicans sent a letter asking the Government Accountability Office to audit the Center for Consumer Information and Insurance Oversight, which is handling implementation of the Affordable Care Act, The Hill's "Healthwatch" reports.
Reps. Dave Camp (Mich.), Wally Herger (Calif.) and Charles Boustany (La.) -- all members of the Ways and Means Committee -- asked GAO to identify the total amount that has been allocated to CCIIO and the sources of that funding. Specifically, they asked for a breakdown of spending on advertising, conferences, polling, salaries and travel (Baker , "Healthwatch," The Hill, 8/9).
The lawmakers also asked for information on how many CMS workers are being used for CCIIO-related activities (Ethridge, CQ Today, 8/9).
The lawmakers also questioned the administration's decision last year to house CCIIO within CMS; the center originally was set up as its own office. While HHS maintained the move would improve efficiency, the Republicans said they were concerned that CCIIO could be siphoning money from Medicare and Medicaid. They said the move could be a way for the center to use CMS funding and be protected from legislation aimed at cutting funding from the health reform law (Baker , "Healthwatch," The Hill, 8/9).
The letter asked GAO Comptroller General Gene Dodaro to respond by Oct. 15 (CQ Today, 8/9).