Republicans say CBO is biased when scoring new CMS pay models

Republican lawmakers believe that the Congressional Budget Office may be biased when evaluating experiments developed by the CMS Innovation Center, an agency created by the Affordable Care Act to test new methods of paying for value in medicine.

“It hurts me and members of this committee to express concerns about the objectivity of the Congressional Budget Office,” House Budget Committee Chairman Tom Price (R-Ga.) said at hearing Wednesday.

The hearing was called to discuss how exactly the CBO finds that the Innovation Center's experiments will save money.

Lawmakers say they are concerned that models may actually increase Medicare costs and reduce quality of patient care. Those concerns grew after the Innovation Center (also known as CMMI) began to mandate involvement in some of its experiments such as the Comprehensive Care for Joint Replacement Model and the proposed Part B drug model.

The Republican critics said they feel they have few legislative options to void or alter the demonstrations. “Unfortunately, under its current analysis, the Congressional Budget Office tells us that any altering of CMMI's demonstration activities would result in a substantial loss in savings,” Price said.

Some lawmakers have gone as far as saying the CBO's perceived biased cost assessments prevent them from suggesting laws to repeal CMMI related proposals, such as such as the proposed Part B pay model, because they know those bills won't get passed if the CBO doesn't report they will save costs.

Price and other lawmakers said they felt CBO's current stance on the Innovation Center's activities appears to make them bias towards the Obama administration. That's a strange comment considering that by criticizing the CBO, Republicans are rejecting Keith Hall, the director of the office who was handpicked by the GOP. Hall served as staff economist for former President George W. Bush.

“Savings assumptions favor CMMI,” Price said. “It is this reasoning – that the executive branch is more effective at legislating than the Congress – that is so concerning.”

During the hearing, Mark Hadley, deputy director of the CBO dismissed the claims of bias and noted that all the agency does is present the facts.

The Affordable Care Act appropriated $10 billion to support CMMI activities initiated from fiscal year 2011 to 2019.

Over 4.7 million Medicare, Medicaid, and CHIP beneficiaries receive care furnished by more than 61,000 providers participating in Innovation Center models, according to the CMS.


Virgil Dickson

Virgil Dickson was reporting from Washington on the federal regulatory agencies. His experience before joining Modern Healthcare in 2013 includes serving as the Washington-based correspondent for PRWeek and as an editor/reporter for FDA News. Dickson earned a bachelor's degree from DePaul University in 2007.

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