Strengthening Innovation in Medicare and Medicaid Act
Sponsored By: Representative Smith, Adrian [R-NE-3]
Introduced
Summary
Reins in the Center for Medicare and Medicaid Innovation by capping tests and forcing transparency. This bill would limit how large and long CMI models can run, require public actuarial and quality data, and add new congressional and public review steps for design, testing, and expansion.
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 0 benefits, 0 costs, 3 mixed.
Medicare and Medicaid patient protections
If enacted, the bill would require more transparency and public input for new Medicare and Medicaid payment models starting January 1, 2027. The government would have to get expert input and allow at least 45 days for public comment on model plans. Within 60 days of enactment the Secretary would have to set up hardship waiver rules for providers and a real-time monitoring and mitigation plan to spot and fix harms. Models would also have to disclose actuarial assumptions and measure patient outcomes and unintended effects.
Congressional and court oversight changes
If enacted, the Secretary would have to send proposed model tests, expansions, or changes to specified House and Senate committees before they start. Congress would have 45 days to pass a joint resolution to disapprove a proposal. The bill would also preserve the ability to go to court to enforce beneficiary protections, while removing a current Medicare duplication prohibition for model actions beginning January 1, 2027.
Caps on Medicare and Medicaid trials
If enacted, the bill would limit early-stage (Phase I) Medicare and Medicaid models. Starting in fiscal year 2027 no more than six new Phase I models could start each year and no more than five mandatory Phase I tests could run at once. Phase I tests would be limited to 5 years and to the lesser of 10% of applicable people or 500,000 beneficiaries. These caps would reduce how many people can be put into mandatory model tests at one time.
Sponsors & CoSponsors
Sponsor
Smith, Adrian [R-NE-3]
NE • R
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
No roll call votes available for this bill.
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