Physician groups, House Republicans aim to strike down IPAB

Key Points

On March 22, the GOP-controlled U.S. House of Representatives voted to repeal the controversial Independent Payment Advisory Board (IPAB), established by the new healthcare law now being challenged in the U.S. Supreme Court, and intended to provide a mechanism to control increasing Medicare costs.

That, of course, has been sought by large numbers of physicians groups, including the American Academy of Dermatology Association, which see the IPAB as an unfettered entity whose purpose will be to slash Medicare reimbursement rates for procedures and services in order to reach pre-established expenditure targets.

Push and pull on IPAB

While Republicans in the Senate are pushing for IPAB repeal, Democrats still are in control there and are not expected to support the measure, which President Obama has promised to veto even if it should pass.

The election-year strategy of House Republicans became clear when they included in the IPAB repeal legislation provisions that would limit medical malpractice awards, also an objective of the medical community, but strongly opposed by many Democratic lawmakers.

While some observers speculated that IPAB repeal might be supported by enough moderate Democrats for it to squeak through the Senate, adding the malpractice caps only served to dilute that support and virtually guarantee the issue will be front and center during the fall campaign, giving them the opportunity to reprise their warning of a "death panel" making life-and-death decisions regarding seniors.

Adding to the uncertainty for physicians is the question of how the Supreme Court will rule on the challenge to the healthcare law it is now considering. Should the court rule the entire law is unconstitutional, the IPAB will be history. However, if the court upholds the law or only tosses out specific provisions, such as the requirement that individuals must purchase health insurance or pay a penalty, then the IPAB will remain.