- Over 650 medical organizations have signed a letter to Congress from the Healthcare Leadership Council (HLC) supporting the elimination of the Independent Payment Advisory Board (IPAB). The HLC joins a chorus of support for two bipartisan bills currently in Congress which would permanently eliminate the Medicare budget panel.
The 15 member IPAB board was created as part of the Patient Protection and Affordable Care Act (ACA). As part of the ACA, the board was the inspiration behind the infamous “death panels” used to scare seniors in several election cycles.
“As constructed, IPAB is granted unprecedented powers – even the ability to change laws previously enacted by Congress – with virtually no oversight. The potential impact of this board causes deep concern among our organizations and the millions of Americans we represent,” the HLC stated in the letter.
The IPAB panel is tasked with making immediate cuts to Medicare outlays if they exceeded a certain threshold.
As the law currently stands, if Medicare funding exceeds set limits, the IPAB must pass immediate reforms, which would be scored in a one-year window. The HLC maintains this would take the focus off long-term planning in exchange for mandated short-term cuts.
The group also voiced concern that Medicare reimbursement cuts would further reduce access for patients and diminish revenues for providers. This cost, they assert, would be passed on to employers and consumers.
“An unelected board without adequate oversight or accountability would be taking actions historically reserved for the public’s elected representatives in the U.S. House and Senate. This is an unacceptable decision making process for a program that millions of our nation’s seniors and individuals with disabilities rely upon,” said the HLC letter.
Opposition to the IPAB stems from the board’s singular ability to “fast track” legislative procedures to cut Medicare payments.
Any recommendations by IPAB automatically become law unless a three-fifths Senate majority blocks it. Furthermore, the IPAB mandate prohibits legislators from modifying its decisions, eliminating any executive or judicial oversight powers.
IPAB has remained vacant, with no confirmed members from either the Obama or Trump administration. This vacancy does not erase the board’s original charge. If Medicare spending levels trigger IPAB action, and no members exist, the HHS secretary would be required to submit ‘fast-track’ recommendations.
Since 2010 when the PPACA went into law, Medicare spending has not hit the levels which would mandate an automatic cut by the IPAB panel
“Economists, however, expect this string of good luck to end this year meaning that either IPAB or the HHS secretary will be required to initiate the process of developing and submitting spending reduction proposals for fast-track consideration by Congress,” stated a recent American College of Radiology (ACR) report.
Signatories of the HLC letter include organizations which represent Medicare beneficiaries and patients, all sectors of the healthcare industry, as well as employers and other purchasers of health care.
“We strongly support bringing greater cost-efficiency to the Medicare program. We also advocate continuing efforts to improve the quality of care delivered to Medicare beneficiaries,” the HLC letter concludes.
“The Independent Payment Advisory Board will achieve neither of these objectives and will only weaken, not strengthen, a program critical to the health and well-being of current and future beneficiaries. We urge Congress to eliminate the IPAB provision.”
Despite both House and Senate bipartisan bills, it remains unclear at this time what action may be taken, or if either bill is voted on at all.