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Ways and Means OKs IPAB Killer Bill by Voice Vote

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Members of the House Ways and Means Committee today agreed by a voice vote to back H.R. 452, the Medicare Decisions Accountability Act bill.

The bill would eliminate a new Medicare cost-cutting entity, the Independent Payment Advisory Board (IPAB).

Ways and Means has primary jurisdiction over the bill.

Another committee with jurisdiction over H.R. 452, the House Energy and Commerce Committee, approved the bill by a voice vote Monday.

Earlier, Democrats on the Energy and Commerce health subcommittee could get only five of the 11 Democrats on the subcommittee to vote against H.R. 452: four Democrats were absent during the subcommittee vote, and 2 crossed party lines to vote against the bill.

Ways and Means Chairman David Camp, R-Mich., and Rep. Wally Herger, R-Calif., the chairman of the committee’s health subcommittee, said in a statement that they believe there is strong bipartisan support for H.R. 452.

“Repealing IPAB reinforces that doctors and patients – not a board of unelected bureaucrats – should be making health care decisions,” Camp and Herger say in the statement.

Congress created the 15-member board with a provision in the federal Patient Protection and Affordable Care Act of 2010 (PPACA).

IPAB provision drafters were hoping to give IPAB the independence and freedom from lobbying to hold down the prices Medicare pays for care.

Exemptions in the IPAB provision would prevent IPAB from affecting the rates Medicare pays to hospitals, hospices and many other care providers, and IPAB would have a direct effect only on Medicare provider rates. But the board could have broad influence over U.S. physician payment rates, because many private insurers base their fee schedules on Medicare fee schedules.

IPAB would not have to hold hearings or solicit public comments before making rate cut recommendations.

The recommendations would take effect unless Congress passed legislation that achieved the same amount of savings.

If IPAB rate cut recommendations take effect, PPACA would make the cuts exempt from either administrative review or judicial review.

Rep. Pete Stark, D-Calif., a strong PPACA supporter, said in his opening remarks at the bill markup session that he agrees with the Republicans on Ways and Means that the IPAB provision is a bad provision.

“Remember, the House included no similar provision in our health reform bill,” Stark said.

Stark said that disagrees with the language Republicans have used to criticize the IPAB provision.

No one should “interpret Republican support to repeal IPAB as sincere interest in preserving Medicare,” Stark said. “They want to end Medicare as we know it, hand seniors an underfunded voucher, and slash and burn funding available for health coverage for seniors and individuals with disabilities. Despite my opposition to IPAB, it is far less dangerous to Medicare than the Republican voucher plan. IPAB doesn’t undermine Medicare’s guaranteed benefits and IPAB’s ability to reduce Medicare spending has guardrails. It doesn’t permit cuts to come from reducing Medicare benefits or from increasing costs on beneficiaries, it prohibits rationing, and it has annual limits on Medicare cuts. The Republican voucher plan has none of these protections.”