According to the letter, "Requiring IPAB to achieve scoreable savings in a one-time period is not conducive to generating savings through long-term delivery system reforms."
The mechanism for cuts is a concern, the letter explained. "The Congressional Budget Office has in fact stated that the [IPAB] Board is likely to focus its recommendations on changes to payment rates or methodologies for services in the fee-for service sector by non-exempt providers. Again, this will have a severe, negative impact on Medicare beneficiaries."
The letter added that having an independent body, specifically made up of individuals who are not healthcare providers "sets a dangerous precedent for overriding the normal legislative process. Congress is a representative body that has a duty to legislate on issues of public policy.
"Abdicating this responsibility to an unelected and unaccountable board removes our elected officials from the decision-making process for a program that millions of our nation's seniors and disabled individuals rely upon, endangering the important dialogue that takes place between elected officials and their constituents."
Lastly, the letter points out that, "If the Board is never made operative, a provision in PPACA transfers IPAB's power to the Secretary of Health and Human Services, concentrating the enormous power in the hands of one individual."