In a new report, the Government Accountability Office identified three key examples of overlap between CMS' Innovation Center and efforts from other CMS offices — posing a risk that CMS may duplicate payments for services.
Established under the Patient Protection and Affordable Care Act, CMS' Innovation Center tests new models for healthcare delivery and payment under the Medicare and Medicaid programs. GAO was asked to review the Innovation Center and examine whether its efforts overlap with those of other CMS offices.
The Innovation Center has focused on the implementation of 17 new models, and the GAO identified three "key examples" of overlap between those models and the efforts of other CMS offices, "meaning that the efforts share similar goals, engage in similar activities or strategies to achieve these goals, or target similar populations," according to the report. The overlapped efforts also have some differences, and CMS says they are intended to be complementary.
The Innovation Center uses a "number of mechanisms" to coordinate its work and avoid duplicate payments between its 17 models and other CMS efforts, according to the GAO report. Still, these precautions are a work in progress.
"For example, largely because of questions raised during GAO's review, the Innovation Center initiated a process to ensure that CMS does not pay for the same service under the contracts in one of its models and those in another CMS office," according to the report. "However, officials told GAO that the center is still working on implementing this process and may need to take additional steps to eliminate any unnecessary duplication."
The GAO recommended that CMS Acting Administrator Marilyn Tavenner direct the Innovation Center to "expeditiously" review and eliminate any areas of duplication in contracts awarded to one of its 17 models.
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Established under the Patient Protection and Affordable Care Act, CMS' Innovation Center tests new models for healthcare delivery and payment under the Medicare and Medicaid programs. GAO was asked to review the Innovation Center and examine whether its efforts overlap with those of other CMS offices.
The Innovation Center has focused on the implementation of 17 new models, and the GAO identified three "key examples" of overlap between those models and the efforts of other CMS offices, "meaning that the efforts share similar goals, engage in similar activities or strategies to achieve these goals, or target similar populations," according to the report. The overlapped efforts also have some differences, and CMS says they are intended to be complementary.
The Innovation Center uses a "number of mechanisms" to coordinate its work and avoid duplicate payments between its 17 models and other CMS efforts, according to the GAO report. Still, these precautions are a work in progress.
"For example, largely because of questions raised during GAO's review, the Innovation Center initiated a process to ensure that CMS does not pay for the same service under the contracts in one of its models and those in another CMS office," according to the report. "However, officials told GAO that the center is still working on implementing this process and may need to take additional steps to eliminate any unnecessary duplication."
The GAO recommended that CMS Acting Administrator Marilyn Tavenner direct the Innovation Center to "expeditiously" review and eliminate any areas of duplication in contracts awarded to one of its 17 models.
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