General Authority to Test Model. Section 1115A(b) of the Act authorizes the Center for Medicare and Medicaid Innovation (“Innovation Center”) to test innovative payment and service delivery models that are expected to reduce Medicare, Medicaid, or Children’s Health Insurance Program (“CHIP”) expenditures while maintaining or improving the quality of care for beneficiaries.
General Authority to Test Model. Section 1115A(b) of the Act authorizes the Innovation Center to test innovative payment and service delivery models that have the potential to reduce Medicare, Medicaid, or CHIP expenditures while maintaining or improving the quality of care for beneficiaries. Section 1115A(b)(2) of the Act requires the Secretary of Health and Human Services (“Secretary”) to select models to be tested where the Secretary determines that there is evidence that the model addresses a defined population for which there are deficits in care leading to poor clinical outcomes or potentially avoidable expenditures. The statute provides a non-exhaustive list of examples of models that the Secretary may select including, “[a]llowing States to test and evaluate systems of all-payer payment reform for the medical care of residents of the State, including dual eligible individuals.”
