Issa plans subpoena of Medicare Advantage pilot project documents

The House Oversight and Government Reform Committee will subpoena documents from HHS relating to the department's $8 billion Medicare Advantage pilot program after the department failed to produce documents requested nearly five months ago to the committee's satisfaction.

The move to a compulsory order followed repeated requests for HHS to voluntarily produce documents detailing its internal deliberations on a pilot program launched in 2010 that provides bonus payments to most Medicare Advantage plans, according to a letter dated Friday (PDF) from Rep. Darrell Issa (R-Calif.), the panel's chairman. The program, an amended and much more expensive version of a pilot authorized by the Patient Protection and Affordable Care Act, drew scrutiny from the oversight panel after the nonpartisan Government Accountability Office found this year that the pilot lacked a legal basis and recommended HHS shut it down.

Issa wrote HHS Secretary Kathleen Sebelius on Oct. 19 that the subpoena was needed after 1,300 pages of documents the department sent the day before "were of no assistance to the committee's investigation."

For instance, the HHS-provided documents did not include any records related to HHS' decision to exempt the pilot program from its long-standing requirement for pilot-project budget neutrality, Issa wrote.

An HHS spokeswoman did not respond by deadline to requests for comment.

Issa and other Republicans allege that the administration launched the pilot project to temporarily mask cuts to the Medicare plans required by the healthcare overhaul. The GAO estimated that the pilot would offset more than 70% of the Medicare Advantage cuts required by the law in 2012 and provide much smaller offsets over the next two years.

Republicans and insurers have warned that the healthcare overhaul's cuts to Medicare plans that cover more than one quarter of the program's beneficiaries will reduce the number and availability of such plans, which would impact beneficiaries.

They have suggested also that because most of the offsets would occur in 2012, the pilot may have been designed only to delay the impacts of the health law's cuts until after the Nov. 6 election.