Medicare & Medicaid

Law could repeal “arbitrary” federal panel


A bipartisan measure introduced earlier this month could repeal the Independent Payment Advisory Board (IPAB), a federal panel charged with reducing health care spending.

The Affordable Care Act in 2010 established the 15-member IPAB to extend Medicare solvency and reduce spending growth through use of a spending target system and fast-track legislative approval process. The yet-to-be-appointed board would only use provider payment cuts to reduce Medicare spending.

Rep. Phil Roe, MD, R-Tenn., and Rep. Linda Sanchez, D-Calif., introduced “Protecting Seniors' Access to Medicare Act of 2015” (H.R. 1190), with 205 additional cosponsors, earlier in February. Companion legislation (S. 141) was introduced by Sen. John Cornyn, R-Texas, in January.

In a letter to both representatives, the AMA expressed support for the legislation.

“Major changes in the Medicare program should be decided by elected officials, not some obscure panel with the power to make indiscriminate cuts that adversely affect patient access to health care,” the letter said.

The letter likened the IPAB to the sustainable growth rate (SGR), calling it “another arbitrary and rigid system that relies solely upon payment cuts.” The AMA also pointed to the SGR as a cautionary tale about policy decisions based on projections that require subsequent adjustments to reflect more accurate data.

In 2003, Congress had to take action to allow the Centers for Medicare & Medicaid Services to correct $54 billion in projection errors under the SGR target. Similarly, the IPAB imposes a rigid budget target prone to projection errors that would force Congress to produce billions of dollars in offsets due to inaccurate calculations, the letter said.

“We appreciate the need to reduce the federal budget deficit and control the growth of spending in Medicare,” the letter said. “However, we believe that this can best be achieved by Congress working in a bipartisan manner to establish new payment and delivery models that give physicians the ability to improve patient care and reduce costs to stabilize Medicare for seniors now and in the future.”

Learn more about IPAB at the AMA’s Web page on advocacy