GOP senators demand HHS redo key Medicare regulation

Seven Senate Finance Republicans demanded Tuesday that federal regulators scrap proposed regulations on care coordination and start over.

The request comes as a growing number of hospitals and clinics are warning that a proposal to reward them for the quality rather than the quantity of care they provide is unworkable. The so-called Accountable Care Organizations are a centerpiece of the healthcare system reforms called for by the Democrats' health law, but hospitals say the proposed regulation is too costly and stringent for them to consider participating.

"We have been struck by the increasingly diverse chorus of concerns many of our nation's leading health care institutions have raised in recent days," the senators wrote in a letter to Health and Human Services Secretary Kathleen Sebelius and Medicare chief Don Berwick. "The concerns … from some of our nation's most knowledgeable and innovative health care providers are clear. Incentives and accountability are misaligned. Detailed requirements are complex and return on investment is uncertain."

Part of the problem, The Hill first reported last week, is that budgetary concerns loomed large as the administration crafted the proposed rule. This resulted in regulations that require strict quality improvements but offer no upfront funding for hospitals to change their processes.

Regulators say the proposed regulation is open for public comment and can be tweaked accordingly. Last week, the Medicare agency unveiled new tools to help hospitals kick-start such care coordination efforts, for example by giving them upfront part of the money they're supposed to save Medicare through more efficient patient care.

The letter is signed by Sens. Tom Coburn (Okla.), Mike Crapo (Idaho), John Cornyn (Texas), Jon Kyl (Ariz.), Mike Enzi (Wyo.), Pat Roberts (Kansas) and Richard Burr (N.C.). The Senate Finance Committee has jurisdiction over Medicare.