Critical Condition

‘Innovation’ Center Has Unilateral Power

As the two-year anniversary of health-care law looms, conservatives have mounted a loud and effective campaign against its individual provisions, such as the individual mandate and the IPAB.

One important but oft-overlooked element of the health-care law is the Center for Medicare and Medicaid Innovation over at CMS. One reason for the center remaining largely under the radar is that its pro-”innovation” mission has sounded fairly innocuous, though also expensive — $10 billion over ten years.

According to a new report by senator-physicians Tom Coburn and John Barrasso, however, the center is more worrisome than its name suggests. The report, which relies on a Congressional Research Service memo to Coburn, demonstrates that the legislation authorizing the center gives Health and Human Services Secretary Kathleen Sebelius and the CMS administrator enormous power to experiment with new payment and delivery systems — which is one thing — but also to impose the results of the experiments without external checks on those results.

Coburn and Barrasso note that CRS found “no references in [the law] to any external reviews or checks on the CMS” in evaluating the results of their experiments. Not only will patients lack judicial and administrative review if they object to the center’s demonstration projects, but doctors will as well. According to Coburn and Barrasso, “health care providers are also legally prohibited from contesting the Secretary of Health and Human Services’ (HHS) use of new payment models.” The “innovation” center appears to be one more way in which the health-care law is going to interfere with the practice of medicine, and one that physicians should start paying more attention to.

Tevi Troy is a presidential historian and former White House aide.

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