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By Nathaniel Weixel
The American Medical Association in a Feb. 27 letter urged Republican and Democratic leaders of the House Energy and Commerce Subcommittee on Health to support a bill (H.R. 452) that would repeal the Independent Payment Advisory Board (IPAB).
The bill was first introduced by Rep. Phil Roe (R-Tenn.) and is scheduled to be marked up in the subcommittee Feb. 29. It has gained bipartisan support (238 HCDR, 12/12/11).
The letter, signed by AMA Executive Vice President and Chief Executive Officer James Madara, was sent to Reps. Joseph R. Pitts (R-Pa.), Frank Pallone Jr. (D-N.J.), Henry A. Waxman (D-Calif.), and Fred Upton (R-Mich.).
According to the letter, AMA believes IPAB would add to the problems caused by the current physician payment formula, “which is plaguing Medicare and the TRICARE military health care program with frequently scheduled cuts.”
The letter cautioned that the IPAB would be an independent body with far too little accountability charged with making important health care payment decisions. This body could implement harmful, across-the-board cuts that would adversely affect access to health care for millions of patients, AMA said, and urged the lawmakers to support Roe's bill.
“Major changes in the Medicare program should be decided by elected officials. We have already seen first-hand the ill effects of the flawed sustainable growth rate (SGR) physician target and the steep Medicare cuts that Congress has had to scramble each year to avoid, along with the significantly increasing price tag of a long-term SGR solution,” AMA said in the letter. “Adding additional formulaic cuts through IPAB is just not rational and would be detrimental to patient care, especially as millions of baby boomers enter Medicare.”
IPAB was created under the Patient Protection and Affordable Care Act and is to begin operating in 2014. In years when Medicare's costs grow faster than target rates, the board's 15 members—appointed by the president—will set program reimbursement policy that will become law unless Congress intervenes.
“At a time in which Congress is struggling to eliminate the SGR, it does not make sense to allow another rigid formula to be implemented that risks a bigger set of problems for a broader cross-section of Medicare services,” AMA said in the letter.
In a Feb. 27 statement, AMA President Peter W. Carmel cautioned against Congress making the same mistakes as it did with the SGR. “Instead of relying on another formula that imposes across-the-board cuts that we know do not work, members of Congress should be taking steps to strengthen Medicare for patients, physicians and taxpayers,” Carmel said. “We have made it clear to Congress that the IPAB is another arbitrary system that could make the same dangerous type of overall cuts.”
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