Home Health & Hospice

House passes IPAB repeal bill

Homecare Insider, June 29, 2015

Last Wednesday, the U.S. House of Representatives passed a bill to repeal the Independent Payment Advisory Board (IPAB) in a vote of 244 to 154—a move that garnered acclaim from a major home health trade association.

“The House took an important step ... by passing legislation to repeal IPAB,” said Val J. Halamandaris, president of the National Association for Home Care & Hospice (NAHC), in a recent statement.
The prospective legislation, entitled the Protecting Seniors’ Access to Medicare Act (H.R. 1190), was first introduced in early March by Congress members Phil Roe (R-Tennessee) and Linda Sánchez (D-California), along with more than 200 original bipartisan cosponsors. It has also gained widespread support from advocacy groups that represent providers across the care continuum.
The IPAB was implemented by the Affordable Care Act to help Medicare offer better beneficiary care at lower costs by recommending targeted policies—such those that would promote coordinated service delivery, reduce system waste, incentivize best practices, and prioritize primary care—that are free from political influence.
But because members of the IPAB are appointed by the administration, rather than elected, and are granted the authority to make recommendations to cut Medicare spending if expenditures reach a certain level, NAHC and other detractors believe the board has too much free reign. In addition, NAHC argues the panel has incentive to make nearsighted decisions that would jeopardize providers’ reimbursement—and patients’ access to care—in order to reach short-term cost savings benchmarks.
“Medicare is a public program and should be governed by a publicly-elected body, not an appointed commission,” Halamandaris stated. “This board currently has the authority to take an axe to Medicare and meddle in payment system reforms, thereby hurting patients across the country. It’s wrong for patients, providers, and strengthening Medicare for the long-term.”
While the House passed the bill, the Senate has not yet approved the legislation. In addition, NAHC points to President Obama’s threat to veto the bill as an outstanding hurdle for passage.
Despite NAHC’s strong support for the bill, the association takes issue with a controversial offset it poses: the Act currently calls for funds to be extracted from the Public Health and Prevention Fund to help support the $7.1 billion increase in direct spending the Congressional Budget Office projects the new legislation would carry down the road.
“NAHC supports efforts to identify an alternative offset before the bill becomes law based on concerns about this specific provision,” the trade association stated.
To read the IPAB repeal bill and track its progress, click here.