House GOP to Sebelius: Why won't you write?

September 27, 2012 at 10:11 AM
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Two Republican lawmakers are demanding that U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius give them more information about a Medicare Advantage quality bonus pilot program.

The lawmakers, Rep. Darrell Issa, chairman of the House Oversight and Government Reform Committee, and Rep. James Lankford, chairman of that committee's technology subcommittee, have complained in a new letter that Sebelius still has not answered a letter on the topic that they sent Aug. 1.

"If the Department continues to ignore the Committee's request, we will consider the use of compulsory process," the lawmakers said in the new letter.

The Centers for Medicare & Medicaid Services (CMS) says it developed the star rating system to give Medicare beneficiaries  information about plan quality. CMS has been using quality survey data and plan administrative data to assign the star ratings.

A provision in the Patient Protection and Affordable Care Act of 2010 (PPACA) requires CMS to use quality information when allocating  Medicare Advantage plan funding. 

Federal law calls for the quality bonus to make up for some of the money Medicare Advantage plans could lose due to PPACA Medicare Advantage subsidy cuts.

Issa and Lankford said in the August letter that Sebelius has decided to spend $8.3 billion on the bonus program without congressional appropriation.

In the earlier letter, Issa and Lankford asked Sebelius whether she believes there are any limits on what the U.S. Department of Health and Human Services can spend on the quality bonus program and to provide documents relating to any bonus program spending limits.

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