Dems Join Republicans to Fight Appointed Payment Board


Efforts to derail the Independent Payment Advisory Board gained a bit of traction as two House Democrats joined their colleagues across the aisle in cosponsoring the Medicare Decisions Accountability Act.

Introduced by Rep. Phil Roe (R-Tenn.) in January, H.R. 452 would repeal the portions of the Affordable Care Act that would create the Independent Payment Advisory Board (IPAB).

The 15-person board, to be appointed by the President, would be charged with recommending ways to reduce Medicare spending based on the Consumer Price Index and other economic indicators. The board would submit recommendations to Congress on how to limit Medicare expenditures each January, beginning in 2015.

If Congress fails to act on those recommendations by August, the recommendations would go immediately into effect.

The IPAB's “sole purpose is to control Medicare costs – giving this board the authority to approve and deny funding for care,” Rep. Roe, who is an ob.gyn., said in a statement. “The IPAB will lack full Congressional oversight, compromising its accountability to the American people.”

The existence of the IPAB “permanently removes Congress from the decision-making process, and threatens the long-time, open, and important dialog between hospitals and their elected officials about the needs of local hospitals and how to provide the highest quality care to their patients and communities,” according to Rick Pollack, executive vice president of American Hospital Association.

The efforts of the IPAB also would be redundant to the Sustainable Growth Rate formula, which is used each year to adjust Medicare spending for physician services, according to its opponents.

“It makes no sense to subject physicians to two separate expenditure targets while at the same time exempting large segments of Medicare providers who are subject to no target at all,” Dr. Michael Maves, executive vice president of the American Medical Association, wrote in a letter to lawmakers.

“We have already seen first-hand the ill effects of the flawed SGR physician target and the steep cuts that Congress has had to scramble each year to avoid, along with the exorbitant price tag required for a long-term SGR solution,” he added.

H.R. 452 is supported by the American College of Cardiology, the American Medical Association, the American Hospital Association, the American Association for Neurological Surgeons, the Alliance for Specialty Medicine, and other medical groups.

The legislation has been referred to several House committees for action and at press time had no Senate counterpart.

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