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Jayapal Applauds Exit of Bad Actors from ACO Reach Program, Calls for Greater Accountability

WASHINGTON – U.S. Representative Pramila Jayapal (WA-07) released the following statement in response to Centers for Medicare and Medicaid Services’ (CMS) announcement of participants in the 2023 ACO Reach program:

“For almost two years, I have been calling on CMS to end the Trump-era ACO Reach program, which allows for further privatization of Medicare. This was also included in the Congressional Progressive Caucus’s list of priority recommended executive actions. As a result of advocacy from inside and outside Congress, while CMS has not yet heeded our call to end the program, CMS has made some important reforms to the program including establishing new criteria for participation in the program. This new criteria excludes health care providers that had previously defrauded and abused Medicare, often at the expense of patient care and wellbeing, and the list of participants for the ACO Reach program that was released today does indeed exclude some of these bad actors who put profits over patient care while simultaneously ripping off taxpayers. 

“However, it’s troubling that a number health care corporations identified by Congress with histories of fraud and abuse have still been given the green light to participate in this program. CMS must take further action to ensure that patient care is the highest priority of any and all participating providers. Corporate profiteering and profit-driven organizations should have no place in the Medicare system. We must fight the privatization of Medicare with every tool we have.”

Last month, Jayapal led a letter signed by more than a dozen members of Congress calling on CMS to conduct further investigation into the participation of Centene, Sutter Health, Clover Health, AdventHealth, Humana, Vively Health, Cigna, Bright Health, and Nivano Physicians from the ACO Reach program following the discovery of documented cases of these providers defrauding Medicare and other government health programs.