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Urology's Advocate on Capitol Hill

Repeal the Independent Payment Advisory Board (IPAB)

Urologists urge Congress to repeal the Independent Payment Advisory Board (IPAB). We urge Representatives to cosponsor H.R. 849, introduced by Representatives Phil Roe, MD (R-TN) and Raul Ruiz, MD (D-CA). We urge Senators to cosponsor S. 251 and S. 260, introduced by Senators Ron Wyden (D-OR) and John Cornyn (R-TX), respectively. Each of these measures would permanently repeal the IPAB.

BACKGROUND
The IPAB would require a board of non-elected government officials to recommend Medicare cuts when spending exceeds a targeted growth rate. These recommendations automatically go into effect unless blocked by a Congressional three-fifths supermajority. Although hospitals and long-term care facilities comprise more than one-third of Medicare spending, they are exempted from IPAB cuts until 2020. This means that a disproportionate share of the burden will fall onto physicians, who make up less than 10% of total Medicare expenditures.

Experts say that in 2017, Medicare spending could finally trigger the IPAB to go into effect – posing an imminent threat to healthcare access for the nation’s 55 million Medicare beneficiaries.

Established by the Affordable Care Act as a tool to help control Medicare spending, IPAB would be charged with making recommendations for cutting Medicare expenditures once the program’s spending growth hits an arbitrary level. As designed, IPAB would usurp congressional authority over the Medicare program while granting unprecedented powers with virtually no oversight. IPAB is allowed broad authority to propose changes to Medicare, which will automatically take effect unless Congress acts.

RATIONALE
IPAB would likely make significant, arbitrary cuts in Medicare payments for healthcare providers. These cuts would have a potentially devastating impact on Medicare patients – affecting access to care as well as to innovative therapies and new care approaches. As designed, IPAB is a blunt instrument that focuses on reducing what Medicare pays for healthcare services rather than on what’s in the best interest of patients.
Urologists and other providers are working hard to keep up with new quality improvement and reporting requirements, in exchange for Medicare incentives that IPAB could cancel out. The cuts could make it more difficult for physicians to see new Medicare patients, or undermine the financial viability of physicians with a large Medicare caseload.

Ultimately, repealing IPAB ensures seniors and their doctors maintain control over their treatment and other healthcare decisions.

CONTACTS
To cosponsor H.R. 849, 
please contact Aaron Bill (Rep. Roe) at 5-5714 or Erin Doty (Rep. Ruiz) at 5-5330. To cosponsor S. 251, please contact Elizabeth Jurinka (Sen. Wyden) at 4-5244.To cosponsor S. 260, please contact Beth Nelson (Sen. Cornyn) at 4-2934.

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