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1 (February 24, 2012)

handle is hein.crs/crsuomaaaaa0001 and id is 1 raw text is: ongressnal Research Service MEMORANDUM February 24, 2012 To: Sen. Tom Coburn Attention: Josh Trent From: Jim Hahn, Specialist in Health Care Financing, 7-4914 Subject: Center for Medicare and Medicaid Innovation This memo addresses certain of your questions about the Center for Medicare and Medicaid Innovation (CMMI). 1 1. Please describe the CMMI authorities outlined in law as specifically as possible. The Social Security Amendments of 1967, as amended by the Social Security Amendments of 1972, provide the Secretary with broad authority to develop and engage in experiments and demonstrations to test new approaches to paying providers, delivering health care services, or providing benefits to beneficiaries participating in federal health care programs. All demonstrations are required to be budget neutral and be approved by the Office of Management and Budget (OMB) prior to implementation. Scope. Section 3021 of the ACA establishes a new §III5Awithin the Social Security Act (SSA) which requires the Secretary to establish the CMMI within the Centers for Medicare & Medicaid Services (CMS).2 The purpose of the CMMI is to test innovative payment and service delivery models to reduce program expenditures under Medicare, Medicaid, and the State Children's Health Insurance Program (CHIP) while preserving or enhancing the quality of care for program beneficiaries. In selecting these models, the Secretary is required to give preference to models that improve the coordination, quality, and efficiency of health care services. In carrying out its functions, the Secretary is required to consult with relevant federal agencies and experts in medicine and health care management. The purpose of the center will be to research, develop, test, and expand innovative payment and delivery arrangements to improve the quality and reduce the cost of care provided to patients. Successful models could be expanded nationally. Testing (Phase I). The Secretary is required to select models that address a defined population with poor clinical outcomes or avoidable expenditures. The Secretary has the authority to limit 1 Responses to additional questions are being prepared by the American Law Division. 2 ACA establishes the Center for Medicare and Medicaid Innovation as CMI; however, CMS uses the acronym CMMI for the Center. Congressional Research Service 7-5700 WWwUcrs~gov