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Fight over Medicare Payment Panel to Ramp Up

By Rebecca Adams, CQ HealthBeat Associate Editor

July 7, 2011 -- Supporters and critics of the Independent Payment Advisory Commission (IPAB), which will recommend Medicare payment cuts when it starts work in 2014, are gearing up for a marathon debate over the issue in two House hearings next week.

The House Budget Committee will start the action on Tuesday with a hearing featuring Health and Human Services Secretary Kathleen A. Sebelius.

Four panels of witnesses—with three House members and a senator on the first panel, followed on the second round by Sebelius—are scheduled to testify at a House Energy and Commerce Health Subcommittee hearing Wednesday.

Beginning in 2014, the commission, which was created in the health care law (PL 111-148, PL 111-152), will have the authority to issue recommendations to cut Medicare spending if it exceeds certain levels. Those recommendations would become law unless Congress overrides them.

Republicans have ramped up their criticism of the board for having too much power and too little oversight, as have health advocacy organizations.

Supporters of the commission say that it will play an important role in restraining the growth of Medicare spending.

Interest groups are planning events around the hearing and sending letters to committee members in advance of the discussion. For example, the Heritage Foundation is sponsoring a forum on Tuesday entitled, “IPAB and Rationing Vs. Choice and Competition.”

The American Medical Association sent letters supporting bills (S 668 and HR 452) that would repeal the commission’s power. The measures were authored by Sen. John Cornyn, R-Texas, and Rep. Phil Roe, R-Tenn.

Another medical provider group that supported the overall law wrote to the House committees to express its concerns about the commission.

"The IPAB would operate under a requirement of creating savings through reductions in Medicare spending, independent of fundamental reforms that would advance long-term improvements in quality, safety, and efficiency. By prohibiting IPAB from altering coverage and benefits for beneficiaries,” wrote Karen J. Nichols, president of the American Osteopathic Association. “Finally, IPAB contributes to the concept of fragmentation by ignoring the growing trend of care being delivered in ambulatory versus inpatient settings.”

 Rebecca Adams can be reached at [email protected]

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