WASHINGTON — More than 270 health care and business
organizations sent a letter to Congress Friday urging elimination
of the Independent Payment Advisory Board.
Created under the Affordable Care Act, the 15-member panel, to
be appointed by the president, would have the power to cut Medicare
payments unless Congress intervenes.
"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 health care costs
that are shifted onto the private sector," read the June 24 letter.
"While we all recognize the need for more sustainable health care
costs, we do not believe the IPAB is the way to, or will,
accomplish this goal."
The American Association for Homecare was among the letter's
signers, which also included the National Association of Home Care
and Hospice, American Physical Therapy Association, AdvaMed and the
U.S. Chamber of Commerce.
Expected to begin operation in 2014, the IPAB would make
recommendations to cut Medicare reimbursements when the program's
costs grow faster than target rates. Unless Congress steps in, the
Department of Health and Human Services is required to implement
The groups' letter said any such reductions would likely be in
the form of payment cuts to providers — and that could mean
more providers leaving Medicare.
"In the past five years for which data is available, the number
of physicians unable to accept new Medicare patients because of low
reimbursement rates has more than doubled," the letter said.
"According to an American Medical Association survey, current
reimbursement rates have already led 17 percent of all doctors,
including 31 percent of primary care physicians, to restrict the
number of Medicare patients in their practices. In all likelihood,
the IPAB will only exacerbate this problem."
The IPAB also sets a dangerous precedent for overriding the
normal legislative process, according to the letter.
"Abdicating this responsibility to an un-elected and
unaccountable board removes our elected officials from the
decision-making process for a program that millions of our nation's
seniors and disabled individuals rely upon, endangering the
important dialogue that takes place between elected officials and
their constituents," the groups said.
Proponents of the independent Medicare board, however, believe
it will help to curb spending growth in the massive program. The
Congressional Budget Office has estimated the IPAB would save $15.5
billion between 2015 and 2019, the years in which its
recommendations will be implemented.
In January, Rep. Phil Roe, R-Tenn., introduced the Medicare
Decisions Accountability Act (H.R. 452) to repeal the
IPAB. In March, Sen. John Cornyn, R-Texas, introduced a similar
measure called the Health Care Bureaucrats Elimination Act (S.