With less media, HHS has now released an annual CMS budget and strategic plan of 321 pages. Here.
|Org Chart; page 4 of 321 pages; click to enlarge|
This performance budget reflects CMS's vision by investing in our people, processes,Recall that in early March 2019 CMS hired its first "Chief Healthcare Informatics Officer" - Dr. Mark Roche, formerly of Northwestern University and NIH - here.
structure, and capabilities. The budget will support initiatives to transform Medicare into an affordable, patient-driven program that encourages innovation and competition. The budget supports tools that permit patient control and provider sharing of secure healthcare data, allowing for better coordination of care and less duplication. Additionally, CMS is proposing to further modernize our programs, address the increasing role of technology in seniors' lives, keep their data safe, and upgrade key information technology systems.
Bingo: Recyling the Eternal Reference to Now Ending Pay-and-Chase
They refer to pay-and-chase (paying for fraud then chasing it) on page 2 and again on page 124. CMS is always transitioning "away from pay-and-chase." It's been the same statement every year for decades.
Congressional Requests for Reports
Each summer Congress issues budget documents which include numerous requests for reports. CMS generally responds in this Spring document. CMS addresses quite a few of these in responses from page 211 ff. This can take the form of a call-and-response, as in these examples:
- Hill: The Committee is concerned about the dramatic increase of pharmacy direct and indirect remuneration [DIR] fees in Medicare Part D, especially the impact of ‘‘pharmacy DIR fees’’ on Medicare Part D beneficiaries who incur high drug costs....
- CMS: In the 2019 Part D proposed rule, published on November 28, 2017, CMS included a Request for Information (RFI) regarding the application of manufacturer drug rebates and prices concessions to drug prices at the point of sale....On November 30, 2018, CMS published the Modernizing Part D and Medicare Advantage to Lower Drug Prices Proposed Rule....
- Hill: Hospital-Acquired Pressure Ulcers - The Committee is aware of recent data from CMS identifying that pressure ulcer discharges have significantly increased...
- CMS: We agree that pressure ulcers are a critical are to address...The Patient Safety 90 Measure...one of the components is pressure ulcer rates...
What's Not There
One of the highest visibility proposals, in October 2018, was an International Price Indexing Model for Part B drug prices proposed by Pres. Trump in a press conference person at HHS. (Here). While this was only a notice that there could be future rulemaking here (based on CMMI authorities), essentially a glorified Request for Information, the IPI idea doesn't seem to be mentioned in the 321 pages of CMS proposals and activities.