TMA Urges IPAB Repeal

TMA and 41 other medical organizations have written congressional leaders and urged them to support legislation [PDF] repealing the Independent Payment Advisory Board (IPAB). Created by the Affordable Care Act, IPAB is a 15-member panel appointed by the president that would recommend cuts in Medicare fees to physicians if federal spending on health care reaches certain levels.

Two U.S. House of Representatives committees – Ways and Means and Energy and Commerce – approved the bill. The full House is expected to vote on it later this month. Modern Healthcare reported March 13 that House Republicans will propose restricting medical liability lawsuits to offset the cost of abolishing IPAB. The Energy and Commerce Committee approved a bill last year that would limit some damages in liability lawsuits and attorney fees and establish a statute of limitations for filing liability lawsuits.

In their letter, TMA and the others contend that IPAB will only worsen problems caused by the Sustainable Growth Rate (SGR) formula that now drives down Medicare payments to physicians. 

"It is estimated that it will now cost over $300 billion to 'fix' the SGR, and we clearly cannot afford the IPAB to become the next SGR," they said. "Today, the price tag for repealing the IPAB is relatively small, so Congress should seize this moment and repeal the IPAB now before the cost to do so becomes prohibitive and access-to-care problems become acute."

Finally, they said, health care professionals "representing roughly 37 percent of all Medicare payments – including hospitals and hospice care – are exempt from IPAB cuts until 2020; thus, IPAB-directed cuts will disproportionately fall on physicians." Physicians already face fee cuts of more than 40 percent over the next decade and could be subject to double jeopardy from combined SGR/IPAB reductions if nothing is done, they added.

TMA strongly supports eliminating IPAB because the issue of Medicare spending is too important to be left in the hands of an unaccountable board with decisions based solely on cost.


Action, March 15, 2012


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