Seema Verma

Seema Verma, President Donald Trump’s nominee to lead the Centers for Medicare & Medicaid Services, told lawmakers on Thursday that she’d make targeting healthcare fraud and abuse a “top priority” should she get the job.

Testifying in front of the Senate Finance Committee, Verma was asked how she’d balance the threat of improper payments with making sure providers are paid in a timely, burden-free manner. Verma said she’d aim to “be on the front end” of identifying fraud, rather than taking a “pay and chase” approach.

Verma was also asked by Committee Ranking Member Ron Wyden (D-OR) about the impact MACRA may have on small and rural healthcare providers. Verma’s response, that small and rural providers may be “reluctant” to assume the risks associated with the program, spurred Wyden to question her commitment to quality-based reimbursements.

“When I listen to that, it sounds a little to me like Ms. Verma wants to keep fee-for-service,” Wyden said.

Verma responded that “there are definitely some concerns with fee-for-service … so I’m not suggesting that that works better. I support efforts to increase coordination of care and to hold providers accountable for outcomes.”

She added that “there’s holding providers accountable for outcomes, and I think it’s another thing altogether accepting risk.”

Committee Chairman Orrin Hatch (R-UT) asked Verma about changes that may be needed to help finance an increasing demand for long-term supports and services, while preserving Medicaid’s fiscal sustainability.

“In terms of the Medicaid program and where we are today, I think that we could do better,” Verma said. “We have the challenge of making sure we are providing better care for these individuals, but the program isn’t working as well as it can. I think there’s an opportunity to make that program work better so we’re focusing on improving outcomes for the individuals that are served by the program.”

Verma also noted that, in confirmed, she would emphasize communication between CMS and providers to identify regulations that may be burdensome or outdated.

As of press time a Senate vote on Verma’s confirmation had not been set.

Click here to view Verma’s confirmation hearing, and to read the statements written by Hatch, Wyden and Verma.