Independent Payment Advisory Board still poses a threat to Medicare, healthcare leader tells Congress

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Mary R. Grealy, president of the Healthcare Leadership Council, urged the House Energy and Commerce Committee Subcommittee on Health to pass a joint resolution by Aug. 15 to eliminate the IPAB once and for all.
Mary Grealy
Mary R. Grealy

The leader of a coalition of 700 healthcare groups testified Thursday morning before a House subcommittee that the Independent Payment Advisory Board still poses a danger to patients and doctors and urged lawmakers to eliminate the board before permanent damage is done to Medicare.

Mary R. Grealy, president of the Healthcare Leadership Council, appeared before the House Energy and Commerce Committee Subcommittee on Health for a hearing on bipartisan legislation to improve the Medicare program. She urged them to pass a joint resolution by Aug. 15 to eliminate IPAB once and for all.

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IPAB was created under the Affordable Care Act to make cuts to Medicare in the event the program’s spending exceeds a target growth rate. The 15-member panel has never been established, so if it’s eventually triggered, its authority to make those cuts will automatically transfer to the sitting secretary of Health and Human Services. Healthcare trade groups have long opposed the IPAB because it means lawmakers won’t have a say on Medicare policy cuts.

The latest Medicare Trustees report predicts that the need for IPAB won’t occur until 2021, but Grealy said Congress can eliminate the threat posed by the mechanism by taking advantage of a one-time opportunity to permanently end the process. A provision in the ACA allows Congress to fast-track the legislation without being subject to filibuster or amendment. But they must take advantage of it by Aug. 15.

Congressmen Phil Roe, R-Tenn., and Raul Ruiz, D-Calif., have introduced the resolution in the House, as have senators John Cornyn, R-Texas, and Ron Wyden, D-Ore., in the Senate.

“The Independent Payment Advisory Board was created with the ostensible purpose of controlling Medicare spending, but it does so in a way that does not improve the health of beneficiaries, does not add value to the Medicare program, and does not respect the prerogatives of the elected members of the legislative branch to set Medicare policy,” she said in her prepared statement (PDF).

When the IPAB process is eventually triggered, Grealy said it will likely focus on short-term savings in the form of payment cuts to healthcare providers. That will continue to widen the gap between what private insurance pays physicians to treat patients and what Medicare pays them, making it even more difficult for Medicare beneficiaries to find physicians. She urged lawmakers to take back their authority to oversee Medicare policymaking and vote in favor of the joint resolution.

House subcommittee members didn’t have time to ask Grealy questions this morning because the panel broke for recess for scheduled votes on the House floor.