CMS Initiatives, ACO agreements, and the Acting Administrator

In a letter to the Republican Governors Association, acting CMS Administrator Marilyn Tavenner announced there would be no deadline for states to decide if they would implement the ACA Medicaid Expansion provision. It further explained that “a state can receive extra funding for Medicaid IT costs and Exchange implementation costs even if it has not yet decided whether to expand Medicaid eligibility or to run its own Exchange.” And those monies received would not be subject to return if the State did not in the end implement the programs. The New York Times reported on Governors that gathered in VA last week in the article, Many Governors Are Still Unsure About Medicaid Expansion.

In other CMS news, the CMS Center for Medicare & Medicaid Innovation is looking for a few good Primary Care Physicians in 8 selected states. The Comprehensive Primary Care (CPC) initiative is a multi-payer initiative fostering collaboration between public and private health care payers to strengthen primary care. Medicare will work with commercial and State health insurance plans and offer bonus payments to primary care doctors who better coordinate care for their patients. Primary care practices that choose to participate in this initiative will be given resources to better coordinate primary care for their Medicare patients. All applications must be submitted by 5:00 pm ET on July 20, 2012.

Earlier this month HHS announced 89 new Accountable Care Organizations (ACO) in a press release. As of July 1st, the new ACOs began serving 1.2 million Medicare patients in 40 States and Washington DC. The 89 ACOs have entered into the required agreements with CMS, “taking responsibility for the quality of care they provide to people with Medicare in return for the opportunity to share in savings realized through high-quality, well-coordinated care.”

It has been 8 months since Marilyn Tavenner took over CMS as the Acting Administrator. It has been two months now with no change on the Senate doing anything to confirm her. Back in May, the Senate Finance Committee Chair Max Baucus made no secret that they had no plans to even schedule confirmation hearings for Ms. Tavenner. He stated that it is “virtually impossible” to see how she could get the support of 60 senators with her role in health reform implementation which will bring on the Republicans’ effort to to block the nomination. The last appointed and confirmed administrator was in 2006.