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 SVS Position on the Independent Payment Advisory Board (IPAB)

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, which 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 “triple jeopardy” with cuts from SGR, IPAB and sequestration.  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. 

SVS is pleased that IPAB repeal, H.R 452 sponsored by Representative Roe, MD (R-TN) and co-sponsored by 234 House members passed the House, but we favor another vote on a “clean” bill.  Attaching IPAB repeal to H.R. 5, a comprehensive medical liability bill which we support, made the vote more partisan and the Senate more unwilling to consider the bill this year. 

Posted July 2012

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VascularWeb® is the prime source for all vascular health and disease information, and is presented by the Society for Vascular Surgery®. Its members are vascular surgeons, specialists, and vascular health professionals who are specialty-trained in all treatments for vascular disease including medical management, non-invasive procedures, and surgery.