Healthways is contesting its performance results in the CMS three-year pilot project designed to test chronic-care management interventions. The agency in January announced that five companies participating in the first phase of the Medicare Health Support program were not meeting its statutory requirements. Participants were authorized to test care-management alternatives on fee-for-service Medicare beneficiaries with heart failure or diabetes.
In a letter to CMS acting Administrator Kerry Weems, Healthways President and Chief Executive Officer Ben Leedle asserted that the company would meet or exceed the statutory requirements in the pilot. The contract on the pilot for the Nashville-based healthcare-management firm ends on July 31. We continue to have a number of unresolved issues related to the design, beneficiary selection, randomization and other aspects of the Phase I pilots, including the fact that CMS did not deliver the pilot population that it was contractually obligated to provide, Leedle wrote.
What the participating companies have been notified of in the meantime are the services theyre providing under this pilot project will have to come to an end at the end of the contract period, said CMS spokesman Peter Ashkenaz.
The program was established by the Medicare Modernization Act of 2003 as a two-phase initiative, although the CMS has decided to hold off on Phase II until an independent evaluation of Phase I is completed in 2011 or 2012. -- by Jennifer Lubell
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