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Debt Commission Falters In Vote

Jeff Elliott for HealthLeaders Media, December 8, 2010

"We are very much opposed to what the commission suggested about the Independent Payment Advisory Board, and their unwillingness to take into consideration what Congress already said: that it not be applied to us through 2019," Nickels said.

If enacted, IPAB would have the authority to impose federal cuts in hospital pay for patients covered by Medicare and Medicaid; raise the IPAB's savings target to 1.5% instead of 0.5% in 2015; impose payment reductions even when Medicare spending does not exceed price index growth rate; and eliminate the trigger that could de-activate IPAB by 2019.

AHA was also disappointed that the commission removed caps on noneconomic damages as it attempted to address tort reform. And the elimination of provider taxes in the Medicaid program would "remove crucial funding for states already under significant budget pressures," said AHA President and CEO Rich Umbdenstock in a statement.

The industry did not find fault in everything the commission was trying to accomplish. It did positively react to the panel's decision to drop cuts to disproportionate share hospitals, which provides funding to hospitals serving high populations of poor and underinsured patients.

It's likely that we have not seen the last of the recommendations, according to Nickels. "This provided a menu of options for both the administration when they put their budget out in February and for the two congressional budget committees," he said. "For us, this becomes problematic because it puts options on the table in terms of cutting Medicare and Medicaid that we don't think should be there."

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