Sunday, February 27, 2011

CMS Budget Request

CMS for FY 2012 is requesting $777 billion, a net decrease of $10.2 billion below the FY 2011 level. The funding request includes $661 million for general IT systems and other systems to manage and administer Medicare Advantage Part D benefit and the CMS data center and telecommunications infrastructure. The request includes $244 million to modernize and transform CMS enterprise-wide IT systems.

The Affordable Care Act provides funding to states and territories to establish their Exchanges. In 2010, HHS awarded $48.8 million to 48 states and the District of Columbia to begin planning for their exchanges. Additional planning and establishment grants will be awarded in FY 2011 with renewals available through January 1, 2015. After the initial implementation, the exchanges are to be self-funding.

To deliver innovations in providing care, Accountable Care Organizations (ACO) are scheduled to begin in early 2012 will enable providers to receive a portion of any savings in the Medicare program resulting from effectively coordinating high quality care. Also, expected in early 2012, the “Medicare Independence at Home” demonstration will use home-based primary care teams directed by physicians and nurse practitioners. In addition, ACO also created the Center for Medicare and Medicaid Innovation to be funded at $10 billion over ten years that will work with private sector partners to find promising models to test.

The budget request also includes savings proposals to offset the cost for two years so that physicians will not sustain cuts resulting from the Sustainable Growth Rate (SGR) formula. The Administration intends to work with Congress to provide longer-term relief for physicians.