Medical Groups Charge Proposed Medicare Payment Panel Could Restrict Patient Access

Nearly 75 healthcare organizations—including the American Hospital Association, the Medical Group Management Association, the Association of American Medical Colleges, the American College of Surgeons, and the California Medical Association—called for Congress to drop the proposed Independent Payment Advisory Board (IPAB) from consideration in the reconciled healthcare reform bill.

If established, the board, which is now included in the Senate-passed reform bill, would "essentially assume authority" over the Medicare program—with the purpose of reducing the "per capita rate of growth in Medicare spending indefinitely," the groups said in a letter to Senate Majority Leader Harry Reid (D-NV) and House Speaker Nancy Pelosi (D-CA).

Since Medicare's growth rate has been "below or equal to growth in the private sector," any reductions by the board would be in addition to the $400 billion to $500 billion savings in provider payments already included in the healthcare reform legislation, they said. This could "jeopardize both access for Medicare beneficiaries and even infrastructures" for the healthcare system, they added.

It was last summer that the White House expressed support for what it called the Independent Payment Advisory Council, which would have the authority to make recommendations to the President on annual Medicare payment rates and other reforms. The President could either approve or disapprove the recommendations, and Congress could intervene within a 30-day period if it disagreed.

In that July letter from White House Office of Management and Budget Director Peter Orszag to Pelosi, he said that approach was similar to a recommendation from Sen. Jay Rockefeller (D-WV) to make the Medicare Payment Advisory Commission (MedPAC) an independent executive branch agency that was designed to improve the efficiency of the Medicare system. The council would feature physicians and other health experts appointed for five-year terms.

The board proposed in the Senate bill would have officials appointed by the president to make decisions. However, replacing elected officials "with political appointments from the President does not remove 'politics' from the equation," the healthcare organizations said.

In addition, the proposal "usurps congressional authority over the Medicare program," they said. This would "greatly limit" the ability of Medicare beneficiaries to improve the program—making it difficult "to include coverage of new and better treatments, procedures, and technologies," they added.