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24-01-2013 | Article

Medical societies view Obama’s Medicare board as a non-starter


AANS endorsement

medwireNews: Congressman Roe of Tennessee and Congresswoman Allyson Schwartz of Pennsylvania have introduced for a second time to Congress the Protecting Seniors' Access to Medicare Act, with its bipartisan legislation to repeal the Independent Payment Advisory Board (IPAB), which Congress' previous session failed to vote on.

The bill is endorsed by the American Association of Neurological Surgeons (AANS), the Congress of Neurological Surgeons (CNS), and 24 other medical societies, who view IPAB as a dangerous arrangement in how Medicare payment policy gets decided on.

IPAB's 15-member board was created by the Affordable Care Act (ACA) to recommend Medicare spending cuts beginning in 2014. Yet, according to an AANS press release, IPAB is a board made up of "unelected and largely unaccountable government bureaucrats" that could force doctors to drop out of Medicare if they make drastic payment cuts, ultimately making health care less attainable for the elderly.

"It will be about rationing," Alex Valadka, Vice President of the American Association of Neurological Surgeons, told medwireNews. "Even the [American Medical Association] will tell you that right now Medicare pays about 80% of the costs of actually caring for a patient. If Medicare reimbursement keeps getting ratcheted down, more physicians will have to drop out."

While IPAB remains relatively unknown among physicians, Valadka hopes to inform them and garner support to repeal it. "Especially doctors who are in the trenches putting on rubber gloves and touching patients as opposed to those in administrative positions who haven't seen a patient in decades," he said.

The controversy concerning IPAB dates back to 2011 when Valadka testified on behalf of the Alliance of Specialty Medicine at a hearing held by the House Energy and Commerce Subcommittee.

At the hearing, Valadka informed members of congress about what he viewed as IPAB's poor concept and structure, beginning with the lack of accountability.

According to the AANS press release, "IPAB severely limits congressional authority and eliminates the transparency of hearings, debate, and the meaningful opportunity of stakeholder input."

The AANS also observed the "fast-tracked" nature of IPAB recommendations that automatically would go into effect unless Congress blocks or amends it by posing plans that match spending or cost-saving targets within seven months - a measure described as "completely unrealistic."

IPAB cuts would also affect providers disproportionately by having approximately 37% of all Medicare payments, including hospitals, nursing homes, and hospices, being exempt until 2020, forcing the remaining providers - such as surgeons - to make up for budget goals.

"I think the vast majority of physicians are charitable, well-intentioned people but as I like to remind politicians, even Mother Teresa had to balance her check book," Valadka observed. "If you can't keep your practice open then no one gets the benefit of your care."

By Peter Sergo, medwireNews Reporter