500 groups urge Congress to kill IPAB

Pressure continues building to kill Medicare's Independent Payment Advisory Board, with more than 500 organizations banding together to send a letter to Congress on Thursday urging its repeal.

"We all share the conviction that the Independent Payment Advisory Board (IPAB) will not only severely limit Medicare beneficiaries' access to care but also increase healthcare costs that are shifted onto employers and working men and women in the private sector," executives from provider, employer, payer and other groups said in a letter from the Healthcare Leadership Council.

The objective of healthcare reform "shouldn't be to arbitrarily cut Medicare spending but rather to achieve better care and improved health outcomes. IPAB is not a mechanism geared to do that," Healthcare Leadership Council President Mary R. Grealy said yesterday in an accompanying announcement.

As now structured, the presidentially appointed 15-person IPAB will have the authority to recommend Medicare spending cuts, which the organizations said would almost entirely come in the form of reduced reimbursements to providers. A supermajority in both houses of Congress is required to overturn board recommendations, the letter noted.

The board will have "unprecedented power with little oversight, even though it has the power to literally change laws previously enacted by Congress," the letter read, noting administrative or judicial reviews of board recommendations implemented by the secretary of U.S. Department of Health & Human Services are prohibited.

"Requiring IPAB to achieve scoreable savings in a one-year time period is not conducive to generating savings through long-term delivery system reforms," the letter continued.

Providers, payers and others have been arguing for an IPAB repeal for some time.

The American Medical Association, for example, sent a letter more than a year ago to a congressional committee supporting proposed repeal legislation, saying it would compound problems caused by the existing physician payment formula.

"We have made it clear to Congress that the IPAB is another arbitrary system that could make the same dangerous type of overall cuts," AMA President Peter W. Carmel, M.D., said at the time.

And as long ago as June 2011, momentum was building in Congress to kill the board. Repeal attempts so far have failed, but Senate Republicans in February reintroduced a bill to repeal IPAB.

Meanwhile, President Obama's fiscal 2014 budget request triggers the board's actions earlier than the GDP plus 1 percent identified in the original legislation.

To learn more:
- read the HLC letter (.pdf)
- here's the announcement
- check out the AMA letter (.pdf)