GAO Questions Legality, Purpose of Billions in CMS Spending

Editor’s Note:  The GAO Testimony, Medicare Advantage: Quality Bonus Payment Demonstration Has Design Flaws and Raises Legal Concerns, is attached here.  Additional information about CMS’ $8 billion boondoggle, including a letter from the GAO General Counsel to Secretary Sebelius, is attached here.

From: CRE

How many billions of dollars is CMS wasting?  In yet more harsh criticism of the agency, GAO, the government watchdog, yet again blasted billions in wastefully and possibly illegal spending by Medicare.

In testimony before the House Committee on Oversight and Government Reform, GAO testified that CMS’ Quality Bonus Payment “Demonstration” Program “Is Unlikely to Achieve Its Research Goal as Designed and Raises Legal Concerns.”  Specifically, GAO explained to the Oversight Committee:

•  the expanded bonuses and higher enrollment mainly benefit average-performing plans….

•  the demonstration, adjusted for inflation, is at least seven times larger than that of any other Medicare demonstration conducted since 1995 and is greater than the combined budgetary impact of all of these demonstrations.

•  our March 2012 report found that the demonstration’s design is inconsistent with CMS’s stated research goal.

•  Furthermore, characteristics of the demonstration raise concerns about the agency’s ability to determine whether the payment changes result in increased efficiency and economy, one of the criterion specified in the law.

•  In closing, given the findings from our program review and legal analysis of the demonstration’s characteristics, our recommendation to cancel the demonstration….