§1395ee Practicing Physicians Advisory Council; Council for Technology and Innovation

Summary

The Secretary must set up a Council for Technology and Innovation inside the Centers for Medicare & Medicaid Services (CMS). The council will be made up of senior CMS staff and clinicians and led by an Executive Coordinator for Technology and Innovation. That coordinator must be a noncareer appointee, report to the CMS Administrator, run the council, act as the main contact for outside groups, and oversee the council’s work. The council’s job is to coordinate how CMS handles coverage, coding, and payments for new technologies and procedures, including new drug therapies, and to share information with other groups that make similar decisions. An ad hoc “Physician-Focused Payment Model Technical Advisory Committee” of 11 members will be appointed by the Comptroller General. Members must be nationally recognized experts in physician-focused payment models, no more than 5 can be providers or their representatives, and none can be federal employees. The Comptroller General will set up public conflict-of-interest disclosures, and members are treated as employees of Congress for certain ethics rules. Initial appointments had to be made by not later than 180 days after April 16, 2015. Members serve 3-year staggered terms, may serve without pay but can get travel expenses, and vacancies are filled the same way as the original appointments. The Assistant Secretary for Planning and Evaluation will provide support, and CMS’s Office of the Actuary will give actuarial help. The Secretary must, by November 1, 2016, make rules (after asking for information) that set criteria for physician-focused payment models; MedPAC may comment on those rules. Individuals and groups can submit model proposals anytime. The Committee will review submissions, give initial feedback, and send written comments and recommendations to the Secretary. The Secretary must post a detailed response on the CMS website. Up to $5,000,000 per fiscal year may be transferred from the Federal Supplementary Medical Insurance Trust Fund to run the Committee. Nothing here limits other model development or testing under related parts of the law.