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Demise of Medicare payment panel imminent?


The U.S. House approved a bill that would repeal a key piece of the healthcare reform law. But what are the chances representatives will get their way once the Senate has its say?

The bill eliminating an independent governing body that would advise Congress on your Medicare payments moved one step closer to extinction on March 22.

The Independent Payment Advisory Board (IPAB), a 15-member panel created by the healthcare reform legislation, would be appointed by the president and confirmed by the Senate by 2015. If a Medicare budget target were exceeded, the panel would attempt to reduce spending growth through congressional recommendations.

Last week, the U.S. House of Representatives voted 223 to 181 to eliminate the panel. The U.S. Senate, however, is unlikely to consider the bill, according to those close to the matter, and the

The American Academy of Family Physicians has not responded to the bill but supported the panel with changes, such as greater congressional oversight and more primary care physician representation. The American College of Physicians also has been silent about the repeal bill but did not endorse the IPAB during healthcare reform public comment period.

The American Medical Association (AMA) has been vocal about its opposition to the panel.

“We applaud the House for voting to eliminate the IPAB, a panel which would have too little accountability and the power to make indiscriminate cuts that adversely affect access to healthcare for patients,” says Jeremy Lazarus, MD, president-elect of the AMA.

House lawmakers included the IPAB repeal in a medical malpractice reform bill that would impose limits on malpractice litigation in state and federal courts, such as capped awards and attorney fees, a statute of limitations, and liability limited to one healthcare professional, according to the Congressional Budget Office.

“We know that these reforms are already working in states such as California and Texas, and implementing them on the federal level will help reduce costs and preserve access to physician care for all patients,” Lazarus says.

Although the IPAB repeal had bipartisan support, including the provision in the larger medical malpractice bill killed most Democratic support.

“As a co-sponsor [of the original bill], I am deeply disappointed by Republicans’ decision to link this legislation to an unrelated and partisan issue,” said Allyson Schwartz, (D-Pennsylvania), in a statement. “This move ensured that repealing IPAB would not be given serious consideration in the House.”

House Republicans urged senators to move on the bill this week.

“As a physician, as a member of Congress, and as a patient in my 60s, I am offended by the IPAB,” former practicing ob/gyn Michael C. Burgess, MD (R-Texas), said in a statement. “IPAB is not accountable to any constituency and only exists to cut provider payments to fit a mathematically created ‘target.’ ”

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