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Medical specialists push back on initiative from healthcare law
Medical specialists are urging regulators to slow implementation of an initiative funded by the 2010 healthcare law that aims to streamline care for some low-income elderly and disabled patients.
In a letter, the Alliance of Speciality Medicine asked the Centers for Medicare and Medicaid Services (CMS) for a one-year delay on the grounds that the current "direction and speed" of the project's implementation would jeopardize payments to medical professionals as well as the care of so-called dual eligibles — people enrolled in both Medicare and Medicaid.
"While the goal of the program is to eliminate duplication of services for these patients," the group wrote, "we are deeply concerned about unintended consequences."
The average cost of care for a dual eligible is five times more than that of a regular Medicare beneficiary, according to the Kaiser Family Foundation. The CMS program would give 15 states up to $1 million to create pilot programs aimed at increasing the efficiency of that care.
"It is unclear from most state proposals what constraints plans will face, if any, in how providers will be reimbursed," the group wrote to CMS Acting Administration Marilyn Tavenner on Thursday.
The concerns were not the first voiced by the medical community over the projects — in April, the president and CEO of the Federation of American Hospitals cautioned "against expediency" in their implementation.
"Many state proposals appear to us to be too ambitious, and to lack the level of detail necessary for CMS, potential enrollees, providers, and other critical stakeholders to assess their readiness," Chip Kahn wrote to CMS.
There are nearly 9 million dual eligibles in the Medicare system, according to the Kaiser Family Foundation.
