Smith, Buchanan, and Wendstrup Introduce Bill to Protect Medicare Patients and Providers

Press Release

Washington, D.C. -- Congressmen Adrian Smith (R-NE), Vern Buchanan (R-FL), and Brad Wenstrup (R-OH) recently introduced H.R. 5125, the Strengthening Innovation in Medicare and Medicaid Act. This legislation aims to restore accountability for the Center for Medicare and Medicaid Innovation (CMMI) through commonsense guardrails.

"The current framework of CMMI is poorly defined, and because of this it frequently fails to provide necessary transparency," said Smith. "This is why I have reintroduced my legislation to minimize uncertainty throughout the health care marketplace. We must provide appropriate oversight of CMMI so that innovation and improvements in health care can continue to develop without unintentionally harming patients and providers."

"As Congressman for one of the largest senior populations in America, I believe it is essential that Congress oversee any changes to how Medicare pays health care providers for their services," said Buchanan. "Unfortunately, Obamacare created a little-known agency called the Center for Medicare and Medicaid Innovation (CMMI) that is not subject to Congressional oversight. As a result, our nation's seniors could face unbridled government overreach with no means of transparency. This legislation puts Congress back in the driver's seat instead of unaccountable bureaucrats."

"As a physician, I believe that encouraging innovation is key to moving our health care system from one that rewards volume of care to one that rewards value of care," said Wenstrup. "Innovative payment models will help us get there, but to make them work, we need increased transparency, guardrails, and efficiency. This legislation would enact key protections for patients and health care providers while empowering Congress with much needed oversight over CMMI."

CMMI was created to rapidly test new methods of payment or patient care intending to lower costs and improve patient outcomes. However, CMMI was given overly broad exemptions from existing regulations and judicial review, allowing these models to make sweeping changes without any Congressional oversight. Overly large and arbitrary models can cause uncertainty for health care providers and force patients into mandatory demonstration projects which impact the way they receive dialysis, cancer treatment, or prescription drugs.

This legislation will reduce the uncertainty for both patients and providers by better defining the phases and steps in CMMI's model testing process. It will ensure new models are appropriately limited in size and scope during initial testing, while reasserting Congressional authority to review model expansion, bringing much-needed transparency to CMMI operations, and creating additional opportunities to improve quality of care for Medicare and Medicaid beneficiaries.

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