Background
Medicare payment policy requires a broad and thorough analysis regarding how it affects providers and beneficiaries. Congress has always played an essential role in shaping policies that meet the needs of their communities and constituents to ensure the health care system is equipped to care for diverse populations of this country. Unfortunately, IPAB, created by the Patient Protection and Affordable Care Act (PPACA), threatens the ability of Congress to ensure access to needed health care. Consisting of 15 members appointed solely by the President, with fewer than half being health care providers and none permitted to be otherwise employed, IPAB will be required to recommend cuts based on unrealistic spending targets starting in 2014. IPAB recommendations are “fast-tracked” and automatically go into effect starting in Fiscal Year 2015 unless blocked or amended by Congress.
Providers representing approximately 37 percent of all Medicare payments, including hospitals and hospice care, are exempt from IPAB cuts until 2020; thus, initial IPAB cuts will disproportionately fall on all other providers including vascular surgeons. Furthermore, without a permanent solution to the Sustainable Growth Rate (SGR) formula, physicians are essentially subject to “double jeopardy” with cuts from both the SGR and IPAB. Finally, not only does the creation of IPAB severely limit congressional authority, it essentially eliminates the transparency of hearings, debate and meaningful opportunity for stakeholder input.The Society for Vascular Surgery® (SVS) is committed to improving the value and cost-effectiveness of health care for Medicare beneficiaries. However, IPAB is not a suitable mechanism to achieve these goals.
Recommendation
SVS strongly opposes IPAB and urges Congress to repeal this section of PPACA. Leaving Medicare payment decisions in the hands of an unelected, unaccountable governmental body with minimal congressional oversight and no opportunity for the public to comment will negatively impact timely access to quality health care for Medicare beneficiaries. Also, no practicing physicians will be permitted to serve on this board. These views are shared by both Republican and Democratic members of Congress, organizations representing seniors, the disabled, other patient groups and health care providers.
