The unintended consequences resulting from CMS’ Five Star Rating System continue to mount, including: 1) A few state governments are evaluating the use of Five Star in their Medicaid pay-for-performance initiatives; 2) HUD has issued a directive related to Five Star that we anticipate will impact FHA lenders, mortgage holders, and facilities; and 3) increased media focus on Five Star.
During its last meeting, the Board of Governors approved a revised approach to address the shortfalls with Five Star. We will proceed as follows:
- Continue to work with CMS to adjust Five Star and elevate our concerns to the new CMS Administrator as soon as an appointment is made.
- Meet informally with the Department of Health and Human Services’ (HHS’) Office of the General Counsel to express concern about implementation of Five Star, citing discussion points made in the legal analysis that was completed by ReedSmith. Note: This is not a threat of litigation; we are simply informing the General Counsel’s Office of our concerns in an effort to advance internal action at HHS/CMS to address the problems with Five Star.
- Leverage the efforts of AHCA members who are already reaching out to their Members of Congress by following through with a selective grassroots effort to encourage Congressional champions to pressure CMS into making changes to Five Star.
- Collect information from our members that clearly illustrate the unintended consequences that have resulted from Five Star.
- Reach out to other stakeholders who either share our concerns or who may inform our efforts to seek additional options to Five Star.
If you have questions, please contact Lyn Bentley at lbentley@ahca.org.