Senate Finance Committee Members Question CMS’ Cost Handling of QIOs
Eleven members of the Senate Finance Committee on Monday sent a letter to CMS saying that funding cuts to the quality improvement organization program "will dramatically reduce the number of hospitals, nursing homes and physician offices" QIOs can assist, CQ HealthBeat reports. CMS contracts with QIOs to improve the quality of care provided to Medicare beneficiaries.
According to the letter, CMS "appears to be imposing dramatic funding cuts of as much as 70% on the core work of QIOs aimed at protecting Medicare beneficiaries, improving patient safety and preventing illness." The senators continued, "We cannot understand the justification for funding cuts of this magnitude." The letter stated, "The unprecedented reduction in funding levels that CMS is now implementing through the contracting process" also "will decimate the critical, local infrastructure in many states that has been developed through this important program over the last two decades." The senators added, "Finally, we have been troubled by a pattern of diversion of monies, which were allocated from the Medicare Trust Fund for QIO contract administration, to other initiatives unrelated to the QIO program."
The senators also questioned an agency directive that QIOs should not include in their contract proposals costs for educating beneficiaries about their rights to file quality-of-care complaints. The senators wrote, "In our view, CMS has failed to fund outreach to beneficiaries, and as a result, Medicare beneficiaries are not aware of their right to complain about the quality of care they have received."
The letter was signed by Sens. Jim Bunning (R-Ky.), Maria Cantwell (D-Wash.), Kent Conrad (D-N.D.), Michael Crapo (R-Idaho), Orrin Hatch (R-Utah), Pat Roberts (R-Kan.), John Rockefeller (D-W.Va.), Ken Salazar (D-Colo.), Gordon Smith (R-Ore.), Debbie Stabenow (D-Mich.) and Ron Wyden (D-Ore.).
CMS said it could not respond to the issues raised in the letter because the agency is in the contract negotiations with QIOs. A CMS spokesperson said that the "President's fiscal year 2009 budget shows the budget for the QIO program as $1.099 billion over the three-year contract cycle. During our last contract cycle the program's budget was $1.23 billion. This constitutes a $130 million or 10.67% funding reduction" (Reichard, CQ HealthBeat, 6/11).
