Defining CMI model testing parameters

(a) Scope and duration of models Section 1115A(a) of the Social Security Act (42 U.S.C. 1315a(a)) is amended by adding at the end the following new paragraph: (6) Scope and duration of models tested Beginning on or after the date of the enactment of the Strengthening Innovation In Medicare and Medicaid Act, for purposes of testing new payment and service delivery models, the Secretary shall limit testing of a Phase I model— (A) to a period not to exceed 5 years; and (B) to the lesser of 10 percent of applicable individuals or 500,000 beneficiaries.. (b) Cap on Phase I model testing Section 1115A(a) of the Social Security Act (42 U.S.C. 1315a(a)), as amended by subsection (a), is further amended by adding at the end the following new paragraph: (7) Phase I model limitations During each fiscal year starting with fiscal year 2027, CMI shall initiate Phase I testing of no more than 6 new models each fiscal year. Additionally, CMI shall not concurrently test more than 5 Phase I models which involve mandatory, involuntary, or compulsory participation.. (c) Required waivers for hardship Section 1115A(a) of the Social Security Act (42 U.S.C. 1315a(a)), as amended by subsections (a) and (b), is further amended by adding at the end the following new paragraph: (8) Hardship waivers Not later than 60 days after the enactment of the Strengthening Innovation in Medicare and Medicaid Act, the Secretary shall develop and implement a plan to allow applicable providers of services or supplies to request a waiver from any requirement of a model if the Secretary determines that such requirement would result in undue economic hardship to such provider or supplier or loss of access to such healthcare services or supplies for vulnerable populations.. (d) Monitoring impact Section 1115A(a) of the Social Security Act (42 U.S.C. 1315a(a)), as amended by subsections (a), (b), and (c), is further amended by adding at the end the following new paragraph: (9) Monitoring impact Not later than 60 days after the enactment of the Strengthening Innovation in Medicare and Medicaid Act, the Secretary shall develop and implement a plan to— (A) monitor continuously and on a real-time basis the effect of a model under subsection (b) on applicable individuals, and mitigate any adverse impact, such as inappropriate reductions in care or reduced access to care; and (B) mitigate any adverse impact that the Secretary determines could affect beneficiary health..