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Nearly two dozen House and Senate Democrats are pressing the Biden administration to remove 10 organizations with documented fraud and waste from the controversial ACO REACH payment model that starts next year.
The letter, released by a collection of 21 House and Senate lawmakers last week, is the latest scrutiny to befall the alternative payment model, which aims to give physician groups a pathway to take on high financial risk and get savings in exchange for meeting spending and quality targets.
“The ability of organizations with known histories of fraud and abuse to take part in the program increases the risks for Medicare beneficiaries and raises concerns that [Centers for Medicare & Medicaid Services (CMS)] screening procedures for participants are inadequate, putting taxpayer dollars at risk,” according to the letter sent to CMS on Dec. 8.