On May 11, ACR President Sharad Lakhanpal, MBBS, MD, and other College members will be in Washington, D.C., to speak in support of proposed legislation or a joint resolution that would repeal the Independent Payment Advisory Board (IPAB).
In an attempt to control future Medicare expenditures, one element of the Patient Protection and Affordable Care Act (ACA) signed into law in 2010 is the formation of the IPAB. This 15-member board could be made up of healthcare providers, employers, third-party payers or other healthcare economics experts who are appointed by the president, as outlined in the ACA. The IPAB will be constituted with members nominated and confirmed if conditions that trigger the IPAB are met, including if a projected five-year average growth in per capita Medicare program spending exceeds a specified target.1
Reasons for Repeal
The ACR has been vocal in calling for the repeal of the IPAB. The College’s primary concern is that IPAB recommendations are not subject to executive, legislative or judicial branch review. IPAB proposals automatically become law unless three-fifths of the Senate vote against the recommendations, or Congress passes legislation that changes how the IPAB achieves targeted savings.
“This is a draconian law, and it needs to be repealed,” says Dr. Lakhanpal. “The rules governing this board give the majority members an autonomy over millions of people enrolled in Medicare and Medicaid and give the board power to make decisions that can’t be challenged or corrected.”
These decisions could put rheumatologists out of business, especially those working in small or rural practices if the IPAB agrees to implement a reimbursement percentage rate that is not sustainable. In this scenario, Medicare patients with arthritis could be restricted from treatment by rheumatologists, who are experts trained and educated to manage rheumatic diseases.
Taking It to The Hill
As the population in this country increases and as people are living longer, healthcare costs are going to go up. The two biggest contributors to cost increases are technology and medications, two factors physicians have no control over, Dr. Lakhanpal explains. “There could be a tipping point where physician payments could be cut to pay for the drugs these same physicians are prescribing, which would be a ridiculous scenario.”
That’s why Dr. Lakhanpal is leading the ACR in speaking on Capitol Hill to repeal the IPAB. He says the ACR’s outreach to Congressional representatives and senators in Washington, D.C., about the need for IPAB repeal has been positive, and he encourages every ACR member to engage in this critical advocacy in their own home states.