[Federal Register Volume 87, Number 205 (Tuesday, October 25, 2022)]
[Notices]
[Pages 64492-64494]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-23206]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Reflect Changes Being Made Within the Center for Medicare and 
Medicaid Innovation (CMMI)

AGENCY: Centers for Medicare & Medicaid Services, Center for Medicare 
and Medicaid Innovation.
SUMMARY: To reflect organizational changes within the Center for 
Medicare and Medicaid Innovation (CMMI).

SUPPLEMENTARY INFORMATION: Statement of Organization, Functions, and 
Delegations of Authority Part F of the Statement of Organization, 
Functions, and Delegations of Authority for the Department of Health 
and Human Services, Centers for Medicare & Medicaid Services (CMS) 
(last amended at Federal Register, Vol. 75, No. 56, pp. 14176-14178, 
dated March 24, 2010; Vol. 76, No. 203, pp. 65197-65199, dated October 
20, 2011; Vol. 78, No. 86, p. 26051, dated May 3, 2013; Vol. 79, No. 2, 
pp. 397-398, dated January 3, 2014; and Vol. 84, No. 32, p. 4470, dated 
February 15, 2019) is amended to reflect organizational changes within 
the Center for Medicare and Medicaid Innovation (CMMI).
    Part F, Section FC. 10 (Organization) is revised as follows:

Center for Medicare and Medicaid Innovation (CMMI), State and 
Population Health (FCPC)

    Part F, Section FC. 20 (Functions) for the organization is as 
follows:

Executive Operations Staff (EOS)

    The Executive Operations Staff (EOS) directs and leads 
administrative operations and provides support to CMMI management and 
staff on the full range of management and related administrative issues 
(i.e., personnel and recruitment issues, staff development, performance 
management, awards/recognition program, organizational analysis, 
correspondence, regulations, legislative and Freedom of Information Act 
activities, facilities management, and time and attendance). EOS is 
proposing the following changes:
    The correspondence and clearance work will be realigned from EOS to 
PPG, Division of Alternative Payment Model Infrastructure (DAPMI). The 
purpose is to streamline and centralize the correspondence and 
clearance process.
    The travel & conference, purchase card & supplies, and overtime & 
compensatory activities will be transitioned to EOS from BSG, Division 
of Budget & Administrative Services. The purpose is to unify the 
Center's business operations and services, enhance continuity in 
administrative services, and enable BSG's budget division to dedicate 
more effort to budget activities.
    Coordinating FAC-COR training activities will be transitioned to 
EOS from BSG, Division of Central Contract Services. The purpose is to 
build a consistent training group within the Center that can track and 
execute COR training needs and enable BSG's contracts division to 
dedicate more effort to centralized contract activities.
    The interagency agreement (IAA) super-user role will transition 
from EOS to BSG, Division of Central Contract Services. The purpose is 
to unify and streamline the Center's centralized contract services 
support.
    The role as the Center's focal CMS Access Administrator (CAA) will 
be transitioned from BSG, Division of IT Operations & Security, to EOS 
to unify the Center's business operations and services and enhance 
continuity in Executive Operations services.

Business Services Group (BSG)

    The Business Services Group provides leadership, direction, and 
guidance to the Center on matters impacting operations for the Center's 
models and other initiatives, including budget, financial, audit/
compliance, travel, acquisition, IT, and project management operations. 
BSG is proposing the following changes:

Division of Budget & Administrative Services (DABAS)

    As discussed above, transition travel & conference, purchase card & 
supplies, and overtime & compensatory activities to EOS. The purpose is 
to unify the Center's business operations and services, enhance 
continuity in administrative services, and enable BSG's budget division 
to dedicate more effort to budget activities.

Division of Central Contract Services (DCCS)

    As discussed above, the interagency super-user role will transition 
from EOS to BSG, Division of Central Contract Services. The purpose is 
to unify and streamline the Center's centralized contract services 
support.
    Coordination of FAC-COR training activities transition to EOS from 
BSG, Division of Central Contract Services (DCCS). The purpose is to 
build a consistent training group within the Center that can track and 
execute COR training needs and enable BSG's contracts division to 
dedicate more effort to centralized contract activities.

Division of IT Operations & Security (DITOS)

    As discussed above, the role of the Center's focal CMS Access 
Administrator (CAA) will be transitioned from BSG, Division of IT 
Operations & Security (DITOS) to EOS to unify the Center's business 
operations and services and enhance continuity in Executive Operations 
Services.
    The Innovation Payment Contract (IPC) will move from DITOS to 
DABAS.

[[Page 64493]]

Division of Application Design and Development (DADD)

    Model Intake will move from the Division of Application Design and 
Development (DADD) to the Division of Program and Project Management 
(DPPM).

Division of Program and Project Management (DPPM)

    The Division of Program and Project Management (DPPM) will be 
consolidated with Division of IT Operations & Security (DITOS) and 
renamed the Division of Systems Support, Operation, and Security 
(DSSOS).
    The Division of Program and Project Management (DPPM) will be 
abolished.
    The proposed reorganization will have four Divisions within BSG. We 
propose to rename three of the four divisions. The 4th Division retains 
the original name.

Prevention and Population Health Group (PPHG)

    The Prevention and Population Health Group (PPHG) develops, tests, 
and implements models focused on advancing prevention and population 
health within the delivery system. PPHG's portfolio includes models 
focused on individual and community-based prevention, social 
determinants of health, Medicaid focused models, and opioids. There 
exist a number of synergies between the portfolios in PPHG and SIG 
including: leveraging new provider types and expanding the care team; 
enabling multi-payer whole system transformation; addressing and 
integrating behavioral health; addressing social determinants; engaging 
with states and with Medicaid as key partners. PPHG is proposing the 
following changes:
    PPHG and SIG will be consolidated and renamed to the State and 
Population Health Group (SPHG). The purpose is to bring all of the 
Center's opioids work under one Group and capitalize on programmatic 
and operational synergies between two portfolios, and allow for better 
management over the combined work.
    All PPHG divisions are being retained, with new names for two 
divisions to align to SPHG.

State Innovations Group (SIG)

    The State Innovations Group (SIG) leverages CMS' role as a payer to 
catalyze delivery system transformation at the State level. SIG's 
portfolio includes models targeting State-based delivery system 
transformation efforts, multi/all payer models, and opioids. SIG's 
portfolio includes models targeting State-based delivery system 
transformation efforts, multi/all payer models, and opioids. Several 
synergies exist between SIG and PPHG, including leveraging new provider 
types and expanding the care team; enabling multi-payer whole system 
transformation; addressing and integrating behavioral health; 
addressing social determinants; engaging with states and Medicaid as 
key partners. SIG is proposing the following changes:
    PPHG and SIG will be consolidated and renamed to the State and 
Population Health Group (SPHG). The purpose is to bring all of the 
Center's opioids work under one Group and capitalize on programmatic 
and operational synergies between two portfolios, and allow for better 
management over the combined work.
    All SIG divisions are being retained, with new names for two 
divisions to align to SPHG. The FTEs for these divisions remain the 
same via the realignment. CMMI proposes to eliminate only the Group 
Director and Deputy Director level leadership positions. CMMI vacant 
management positions will be repurposed into new management slots. The 
changes here will have no effect on the staff or budget.

Division of State Innovations Models

    The Division of State Innovations Models will be realigned to SPHG 
and renamed to the Division of State Based Initiatives (DSBI).

Division of All-Payer Models

    The Division of All-Payer Models will be realigned to SPHG and 
renamed to the Division of Multi-Payer Models (DMPM).

Seamless Care Models Group (SCMG)

    The Seamless Care Models Group identifies, designs, and tests 
innovative health care payment and delivery models that enable health 
care professionals to work together to care for patients across the 
continuum of health and different care settings. These models test 
accountability for population health and total cost of care in both 
fee-for-service and Medicare Advantage, and explore improvements to 
Medicare Part D. In addition to models for the general Medicare 
population, SCMG tests innovative payment structures for special 
beneficiary populations with unique needs, such as those with specific 
diseases or living in rural areas. Given the diversity of the 
portfolio, SCMG is seeking to streamline work captured within the group 
to focus on population risk and to realign work into more sensible 
model topic divisions. SCMG is proposing the following changes:

Division of Advanced Primary Care

    Realignment of models dedicated to creating value-based care at the 
physician group practice level housed in the Division of Advanced 
Primary Care to the Patient Care Models Group (PCMG).

Division of Delivery System Demonstrations

    Realignment of health plan innovation models in Medicare Part C and 
Part D from the Division of Financial Risk into the Division of 
Delivery System Demonstrations.
    Rename the Division of Delivery System Demonstrations to the 
Division of Health Plan Innovation.

Division of Special Populations and Projects

    Realign staff and rural health projects (e.g., Rural Community 
Hospital and Frontier Community Health Integration Project 
Demonstrations) from the Division of Delivery System Demonstrations to 
the Division of Special Populations and Projects given this Division's 
focus on special beneficiary populations.

Patient Care Models Group (PCMG)

    The Patient Care Models Group identifies, designs, and tests 
innovative health care payment and delivery models to transform 
traditional fee-for-service payment into value-based design through 
total cost of care and prospective episodic payment, along with other 
payment structures, that leverage risk at critical points along an 
acute care continuum. These models largely target high-cost, fragmented 
specialty care along with models dedicated specifically to creating 
risk for physicians or providers as the accountable entity. PCMG also 
designs and implements payment models for post-acute and seriously ill 
populations. PCMG works on improving the accuracy of payment in fee-
for-service, such as drug pricing, to move current payment levels 
closer to value and increase the accuracy of value payment targets 
built on fee-for-service payments.
    PCMG is proposing the following changes:

Division of Technical Model Support (DTMS)

    PCMG will eliminate the Division of Technical Model Support (DTMS), 
which has historically provided support functions of legal review and 
drafting of legal documents, data analytics, and

[[Page 64494]]

operation approach, in light of the centralization of these support 
functions under PPG.

Division of Advanced Primary Care From SCMG

    As discussed above, PCMG will acquire the Division of Advanced 
Primary Care from SCMG, along with its primary care models, as the 
physician is the accountable entity under these models. This creates 
five model operations divisions within PCMG.

Policy and Programs Group (PPG)

    The Policy and Programs Group (PPG) leads CMMI's portfolio analysis 
process including inventorying concepts as they are considered for 
inclusion in the portfolio, cataloging final documentation on 
innovations tested by CMMI.
    PPG is proposing the following changes:

Division of Alternative Payment Model Infrastructure

    As discussed above, the correspondence and clearance work will 
realign from EOS to the Division of Alternative Payment Model 
Infrastructure. The purpose is to restructure the clearance process to 
involve the initial legal policy review and coordination with the 
clearance team, allowing for more targeted distribution and effective 
outcomes.

Division of Data Analytics

    The mission and functions of the Division of Data Analytics will be 
reframed by providing structured data analytics, guidance, and 
technical support for new model development, existing model operations, 
data dissemination to model participants, payment policies and 
methodologies (e.g., risk adjustment), and educating staff on data 
availability, resources, and analytic methodologies.

Learning and Diffusion Group (LDG)

    The Learning and Diffusion Group (LDG) provides leadership and 
strategic planning for a broad set of learning activities aimed at 
achieving rapid and broad-scale adoption of effective payment and care 
delivery models that improve health care and health for all Americans. 
LDG is proposing the following changes:

Division of Model Learning Systems (DMLS)

    The proposed reorganization will consolidate all model-specific 
learning work into the Division of Model Learning Systems (DMLS).
    LDG will administer model-specific learning system work from DMLS, 
enabling more seamless knowledge sharing and insight, efficient 
communication across model teams, and flexibility in work coverage. 
Model-specific learning system work will continue to include contract 
procurement and management, learning system design, implementation, 
evaluation, and refinement.

Division of Improvement Networks and Regional Engagement (DINRE)

    The proposed reorganization will consolidate all cross-model 
stakeholder and engagement work, cross model learning data analytics, 
and model communication platforms into the Division of Improvement 
Networks and Regional Engagement (DINRE).
    The Division of Improvement Networks and Regional Engagement 
(DINRE) will be renamed to Division of Analysis and Networks (DAN), to 
reflect its new portfolio better.

Division of Cross-Model Learning and Improvement (DCMLI)

    Abolish the Division of Cross-Model Learning and Improvement 
(DCMLI) after reallocating its work to a remaining division.
    Authority: 44 U.S.C. 3101.

    Dated: October 20, 2022.
Xavier Becerra,
Secretary, Department of Health and Human Services.
[FR Doc. 2022-23206 Filed 10-24-22; 8:45 am]
BILLING CODE 4150-28-P