Bill aims to repeal IPAB

A bipartisan bill, backed by the American Medical Association, aims to repeal the controversial Independent Payment Advisory Board, a key provision of healthcare reform.

IPAB is a provision in the Affordable Care Act to curb Medicare spending, Sherry Glied (pictured right), former Health & Human Services' assistant secretary for planning and evaluation during Obama's first term, explained at last week's Society of American Business Editors and Writers in New York City. Repealing it would cost $3 billion, according to Congressional Budget Office estimates, noted the Columbia University healthcare policy professor.

This cost-control board is supposed to make recommendations on how to contain spending in the Medicare program. Contrary to some public opinions, the IPAB isn't a set of 15 bureaucrats issuing rules on how to provide care, experts told FierceHealthcare at the conference.

The president selects the 15 members, who are confirmed by the Senate, explained EJ Mitchell (pictured left), managing editor of Medicare News Group, an independent resource for journalists. The board members must include healthcare professionals, economists and consumers, and their recommendations cannot ration care, which is illegal. Their recommendations also must be approved by Congress. If IPAB fails to come up with recommendations, then the Senate does.

"There's been criticism that IPAB delegates power that is usually reserved for the executive branch," said Stuart Guterman (pictured right), vice president of The Commonwealth Fund.

IPAB has been the target of both Democratic and GOP criticism, with fears that care and finance decisions will rest on the shoulders of these sole 15 members. Reps. Phil Roe (R-Tenn.) and Allyson Schwartz (D-Pa.) yesterday introduced the repeal bill with 83 cosponsors, Law360 reported.

In the public eye, IPAB has been likened to the much discussed "death panel," which is "perhaps the most prominent example of misinformation about health reform," according to research to be published in February's Medical Care journal. Coined by Sarah Palin during her 2009 bid for vice president, the myth of the "death panel" just won't die, researchers noted.

Providers also have been leery of the cost-containment board.

"IPAB is a panel that would have too little accountability and the power to make indiscriminate cuts that adversely affect access to healthcare for patients," AMA said yesterday. "IPAB would be another arbitrary system that relies solely on payment cuts," the association said about the cumulative effects of cuts related to the sustainable growth rate formula.

Will IPAB survive? Medicare New Group's Mitchell said, "Who knows, in this political climate, if anything will come of it."

For more information:
- see the AMA statement
- here's the research announcement
- read the Law360 article (registration required)

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