Health Insurance Report™ helps you track and analyze legal, legislative, and regulatory developments affecting the health-insurance industry throughout implementation of the Affordable Care Act...
The House Oversight and Government Reform Committee Oct. 22 sent a subpoena to the Department of Health and Human Services for documents related to the creation of a Medicare managed care demonstration project, a committee spokesman told BNA.
Committee Chairman Darrell E. Issa (R-Calif.) last week threatened HHS with a subpoena for failing to turn over relevant documents related to the Medicare Advantage Quality Bonus Payment Demonstration.
In an Oct. 17 letter to HHS Secretary Kathleen Sebelius, GOP committee leaders said the department had failed to provide information requested numerous times about the program and that the committee would begin the “compulsory” process to obtain them if not provided by Oct. 18.
The committee said HHS late Oct. 18 provided 1,300 pages of information, but they did not contain enough detail about the demo.
HHS declined to comment on the issue Oct. 22.
Committee Republicans have charged HHS with using the demo to defray Medicare Advantage reimbursement cuts in the Affordable Care Act to help President Obama's standing with seniors before the November election. The department has denied the charge, saying the demo will allow HHS to test new ideas for saving Medicare money and is improving the quality of MA plans.
Republicans also have pointed to a recent Government Accountability Office report that found the demo was unlikely to produce meaningful results and questioned HHS's authority to establish the demo, which will cost $8.3 billion over 10 years (see previous article).
Committee Democrats have said HHS could have done a better job of explaining the demo, but said the investigation is overtly political.
The Centers for Medicare & Medicaid Services rates MA plan sponsors for quality on a one-to-five star scale, with five stars representing the highest quality. The demonstration offers plans bonuses if they have a rating of at least three stars.
In contrast, under ACA, MA benchmarks would have been increased so that plans would be required to have four or five stars to receive bonuses.
By Steve Teske
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