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Strengthening Medicare and Medicaid Innovation: New Rules for Model Testing.

This act modifies how new payment and service delivery models are tested within Medicare and Medicaid. It limits the duration and scale of tests, introduces hardship waivers for providers, and increases Congressional oversight over model expansion. The goal is to improve control over healthcare innovations to protect patients and providers.
Key points
Limiting the testing of new healthcare models to 5 years and a maximum of 500,000 beneficiaries in the initial phase.
Introducing the possibility for healthcare providers to request a waiver from mandatory model participation if it causes undue economic hardship or loss of access for vulnerable populations.
Increasing Congressional oversight over the expansion of tested models – Congress has 45 days to disapprove a proposed expansion.
Requiring continuous monitoring of the impact of tested models on patients and mitigating adverse effects, such as reduced access to care.
Enhancing transparency in the model testing process through mandatory public input and consideration of stakeholder feedback.
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Additional Information
Strengthening Innovation in Medicare and Medicaid Act
Print number: HR 5125
Sponsor: Rep. Smith, Adrian [R-NE-3]
Process start date: 2021-08-27