The Independent Payment Advisory Board (“IPAB”) was established by the Patient Protection and Affordable Care Act (“PPACA”). The IPAB will be comprised of 15 individuals appointed by the President. The responsibility of the IPAB is to make recommendations to Congress that must be acted on within a designated time frame or the recommendations become law. Bad idea; think about it:
1) Fifteen (15) political appointees will have the ability to make laws relating to the delivery of healthcare, Medicare covered services, and Medicare payments for covered services. I was always under the impression that this was the responsibility of the legislative branch of the federal government, individuals that were elected by the citizenship, not political appointees.
2) While Congress can take action to avert any potential actions of the IPAB, most Americans have seen how Congress deals with controversial issues, e.g. the increase in the debt ceiling, healthcare reform, etc. It would be easy for Congress to avoid any issue and blame the impact on the IPAB when their recommendations become effective.
3) Potentially the IPAB may find itself examining and making recommendations, which could become lase, relating to narrowly focused healthcare related issues that ignore broader issues.
4) The IPAB will not be accountable. An unanswered question would be the ability of consumers, healthcare providers, and others to provide meaningful input.
5) The qualifications of the members of the IPAB become significant given the power they eventually yield over Medicare benefits, coverage, payments, etc. Such unaccountable powers should definitely not be placed with persons highly experienced with various healthcare-related issues. The individuals should not be, in any way, associated with special interest groups whereby they are influenced directly or indirectly from those who may benefit from such recommendations.
Many potentially impacted groups have expressed their opposition to the formation of the IPAB, including the National Association for Home Care & Hospice (NAHC) and the Leadership Council of Aging Organizations (LCAO). Healthcare providers and consumers alike should take pause and recognize the inappropriateness of the formation of such a powerful group of political appointees with no effective oversight process.