The 21 lawmakers, led by Massachusetts Sen. Elizabeth Warren and Washington Rep. Pramila Jayapal, sent a letter to CMS Administrator Chiquita Brooks-LaSure Dec. 8.
The lawmakers expressed concerns the ACO REACH program could “provide an opportunity for healthcare insurers and providers with a history of defrauding and abusing Medicare and ripping off taxpayers to further encroach on the Medicare system,” according to a news release from Ms. Warren’s office.
In the letter, the lawmakers named Centene, Clover Health, Humana, Cigna and Bright Health as organizations they were concerned about participating in the new ACO model because of allegations they overcharged the government through Medicare Advantage and other issues.
Nearly every major payer has faced allegations of overcharging the federal government through the Medicare Advantage program.
The new cohort of ACO REACH — or Realizing Equity, Access, and Community Health — participants begins on Jan. 1, per CMS. The model is an alternative payment system for Medicare members prioritizing equity and outcomes.
Read the full letter here.
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