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Medicare payment panel: Close to death?


An independent board that would have had a say over how much Medicare pays you may have been dealt a death blow by two powerful Congressional committees.

Last week, the House Energy and Commerce Committee and the Ways and Means Committee passed the Medicare Decisions Accountability Act (HR 452). The bill repeals the Independent Payment Advisory Board (IPAB), a 15-member panel created by the Patient Protection and Affordable Care Act with members who were to be appointed by the president and confirmed by the Senate. If a budget target was exceeded, the panel would attempt to reduce spending growth through congressional recommendations. The panel had not yet been filled, and was not scheduled to begin its work until 2015.

The bill must be approved by Congress and the president to formally kill the IPAB.

Physician groups, including the American Medical Association (AMA), the American Osteopathic Association, and the Association of American Medical Colleges, support the bill and the IPAB repeal.

The American College of Physicians favors reforming but not repealing the IPAB, whereas the American Academy of Family Physicians have not responded to the news, although the ACP had originally requested more Congressional oversight of the panel.

We applaud the House Energy and Commerce Committee for passing HR 452 legislation,” says AMA President Peter W. Carmel, MD. “The IPAB would have far too little accountability and the ability to make across-the-board Medicare cuts. This is not what we need at a time when Congress is already struggling to eliminate a failed formula that threatens access to care for seniors and military families.”

The Congressional Budget Office (CBO) estimated that without the panel, spending would increase $3.1 billion through 2022. The CBO noted that its estimate is “extremely uncertain” because it is not clear whether the IPAB would be needed to reduce costs.

Although the bill has bipartisan support, not all lawmakers endorsed repealing the committee.

“IPAB was created to be a back-stop—and let’s be clear, that is what it is—in the event that the other delivery system reforms don’t fully achieve the expected results,” wrote Rep. Henry Waxman (D-California) to the Committee on Energy and Commerce’s Health subcommittee. “We all hope the IPAB will be irrelevant. If the act works as we expect, it will be. But in either case, beneficiary benefits and access to care will be protected.”

Nancy-Ann DeParle, deputy White House chief of staff, criticized the bill, writing that the IPAB “strengthens traditional Medicare, making it sustainable for doctors, patients, and taxpayers.”

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