Independent Payment Advisory Board: 6 Things to Know

There have been widespread calls to repeal the Independent Payment Advisory Board, but as both parties seek to reduce the federal deficit, proponents see it as an effective way to keep Medicare costs in line, according to report by the Washington Post.

 

Here are six aspects cited by the Post on the controversial board, which was created by the healthcare reform law.

 

1. How panel would implement cuts. Beginning in FY 2015, if Medicare is projected to grow too quickly, the IPAB will send binding recommendations by the beginning of each year to reduce spending to Congress. If Congress doesn't approve of them, it must pass alternative cuts of the same size by August or a supermajority of the Senate can vote to amend the IPAB recommendations. If Congress fails to act, the IPAB cuts would be implemented automatically.

 

2. How members will be chosen. The IPAB will have 15 full-time members and only a minority of them can be healthcare providers. The president nominates 12 members based on suggestions from leaders of both parties in Congress but can nominate the three others without input. All nominees then have to be confirmed by the Senate. President Obama hasn't nominated anyone yet but has said he hopes to name "doctors, nurses, medical experts and consumers." Board members serve six-year terms and cannot hold any other jobs.

 

3. How IPAB would slow Medicare spending. The board would recommend reductions if Medicare per-capita spending is projected to exceed specific targets. From FY 2015-2019, the target is based on inflation gauges. Beginning in 2020, it is based on GDP growth plus one percentage point. Rather than impose a "hard cap" on spending, the board would recommend ways to reduce spending.

 

4. President wants stronger panel. In releasing his deficit-reduction plan, President Obama called for increasing the panel's authority. He said the IPAB would be critical to controlling the costs of the Medicare program, estimated at $524 billion in fiscal 2010.

 

5. What political opponents say. Provider groups are concerned they wouldn't have the time or ability to counter the board's planned cuts within the accelerated timetable for Congressional action. GOP and some Democratic lawmakers say the IPAB would usurp powers that should belong to Congress and are pressing for repeal of the provision. Further, House Budget Committee Chairman Paul Ryan (R-Wis.) charges it would ration healthcare.

 

6. Board may not act for a decade. If projected spending doesn't exceed targets, the board isn't required to make recommendations. In fact, the Congressional Budget Office in March said Medicare is expected to stay within targets for almost a decade. But those expectations could prove to be wrong.

 

Read the Washington Post report on the healthcare reform law.


Related coverage on the Independent Payment Advisory Board:

HHS Head: Payment Board Preferable to GOP Medicare Revamp

While President Calls to Enhance Payment Board, Opposition Grows

GOP Senators Reintroduce Bill to Abolish Rate-Setting Panel


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