Coats, Bucshon, Brooks Ask Secretary Burwell to Terminate Second Evaluation of HIP 2.0

 Senator Dan Coats (R-Ind.), Congressman Larry Bucshon (R-Ind.) and Congresswoman Susan W. Brooks (R-Ind.) sent a letter to Health and Human Services (HHS) Secretary Sylvia Burwell asking her to terminate a Centers for Medicare & Medicaid Services-led second evaluation of Indiana’s Healthy Indiana Plan (HIP) 2.0 waiver.

Under an agreement with HHS, Indiana must submit an interim evaluation of HIP 2.0 by mid-2016. The State of Indiana already has contracted with an independent consultant to perform this review. In the letter, Coats, Bucshon and Brooks say, “The State is using an independent evaluator, as has been the case during the HIP program’s entire eight-year history. This evaluation process has worked well in the past.”

The members also write that the second evaluation is “a highly unusual action that is duplicative of the effective process under which waiver programs like HIP have previously been evaluated. Furthermore, the selection of a known critic of HIP 2.0 as part of the CMS-led evaluation team calls into question the impartiality of this additional review. As a result, we urge you to terminate this additional CMS-led evaluation.”

Coats is a member of the Senate Finance Committee and Bucshon and Brooks are members of the House Energy & Commerce Committee. These committees have legislative jurisdiction over Medicaid.

The full text of the letter follows:

The Honorable Sylvia Burwell
Secretary of the Department of Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201

Dear Secretary Burwell:

We write to express concern with the decision by the Centers for Medicare and Medicaid Services (CMS) to conduct a second evaluation of the Healthy Indiana Plan (HIP) 2.0 waiver. As noted by Indiana Governor Mike Pence in his letter to you of December 3, 2015, this is a highly unusual action that is duplicative of the effective process under which waiver programs like HIP have previously been evaluated. Furthermore, the selection of a known critic of HIP 2.0 as part of the CMS-led evaluation team calls into question the impartiality of this additional review.  As a result, we urge you to terminate this additional CMS-led evaluation.

As you know, the State of Indiana worked in good faith with CMS for over two years to reach an agreement on the expansion of Indiana’s homegrown, health savings account-based HIP program. It is our understanding that the agreement between CMS and the State calls for very detailed evaluation protocols, which are much more rigorous than those found in previous HIP waivers approved by CMS. The State is using an independent evaluator, as has been the case during the HIP program’s entire eight-year history. This evaluation process has worked well in the past.

We are concerned that CMS has now decided to alter the process by separately contracting for a second review of the HIP 2.0 program. To our knowledge, CMS is not singling out any other waiver in any other state for special review, and the agency has not conducted any such additional waiver reviews in well over a decade. In addition, the Urban Institute, part of CMS’s team of contractors, is on record having levied policy-based criticism against the HIP model prior to being selected as program evaluator. The demonstrated bias of the Urban Institute calls into question its ability to conduct a fair and impartial review the HIP program.

We are confident that any unbiased, empirical study of HIP 2.0 will confirm the value of its underlying model and the positive results it has produced for low-income Hoosiers. However, the second evaluation set in motion by CMS does not meet acceptable standards for evaluation and is duplicative of long-standing review practices. For these reasons, we respectfully request immediate termination of the CMS-led evaluation of the HIP 2.0 program.

Thank you for your prompt attention to this matter.

Sincerely,

Dan Coats

United States Senator

Larry Bucshon

Member of Congress

Susan W. Brooks

Member of Congress