Thursday, February 28, 2013

TMA Urges Passage of IPAB Repeal Bill

The following is a letter by Texas Medical Association (TMA) President Michael E. Speer, MD, on behalf of TMA to U.S. Sen. John Cornyn (R-Texas) regarding the Independent Payment Advisory Board (IPAB) created by the Patient Protection and Affordable Care Act (PPACA).

Dear Senator Cornyn:

On behalf of the 47,000 physician and medical student members of the Texas Medical Association, I am writing to thank you for filing S 531, the Protecting Seniors’ Access to Medicare Act of 2013.

Repealing the Independent Payment Advisory Board (IPAB), created in the Patient Protection and Affordable Care Act (PPACA), is one of TMA’s top legislative priorities. Not only do we sincerely appreciate you filing S 531, but we’re also grateful for you publicizing its importance to the nation’s health care.

For years, we have shared with you our concerns over the damage being done to the practice of medicine by the annual threat of huge cuts in Medicare payments because of the flawed Sustainable Growth Rate (SGR) formula. We are heartened by recent signs of bipartisan progress in replacing the SGR with a payment system that reflects physicians’ growing costs of caring for our patients.

Replacing the SGR will be meaningless, however, unless Congress also repeals the IPAB. Leaving both in place would create cruel and unusual double jeopardy for physicians who want to care for senior citizens and military families. The PPACA created the 15-member IPAB to recommend measures to reduce Medicare spending if costs exceed targeted growth rates set by the Centers for Medicare & Medicaid Services.

The PPACA prohibits the panel from recommending changes to Medicare eligibility or coverage, or other factors that drive utilization of health care services. This means the board will have only one option — cut payments. And through 2019, hospitals, Medicare Advantage plans, Medicare prescription drug plans, and health care professionals other than physicians are exempt. That leaves the board only one option — cut Medicare payments to physicians. Cuts the board recommends will take effect automatically unless Congress acts to suspend them.

As we’ve seen with the SGR, it’s obvious that cuts the IPAB enacts will devastate Medicare beneficiaries’ ability to find physicians to care for them. A recent TMA survey found that the number of Texas physicians accepting all new Medicare patients dropped from 66 percent in 2010 to 58 percent in 2012. That’s part of a trend that’s seen the number decline steadily from 78 percent in 2000.

The issue of Medicare spending for 3.8 million Texans is too important to be left in the hands of an unaccountable board that makes decisions based solely on cost.

Thank you again for filing S 531. We stand ready to help you move this important piece of legislation forward.


Michael E. Speer, MD
President, Texas Medical Association
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