Independent Payment Advisory Board

• Establishes an “Independent Payment Advisory Board” that would annually, beginning in 2014, develop a proposal that includes recommendations toreduce the rate of Medicare spending growth to meet specific targets.
  • Prior to 2018, the target rate is the average of the urban CPI and urban medical care component of the CPI; beginning 2018, the target rate is GDP + 1%.
  • Hospitals and many types of providers of services and suppliers are excluded from recommendations that would take effect prior to 2020.
  • Specifically directs that the Board may look at reductions in MA and Part D payments to account for administrative costs and profit, deny high bids and/or reduce/eliminate performance bonuses to bring down the overall rate of growth for the Medicare program.
  • Proposals are not permitted to include any revenue raised from beneficiary premiums or cost-sharing, benefit or eligibility restrictions.
  • Directs the President to send the proposal to Congress within 2 days, which is directed to introduce it in both Senate and House with provisions for automatic, expedited consideration with limited debate.
  • If no proposal is sent in a required year, HHS is directed to develop a proposal based on the Board’s recommendations.
  • If no bill is enacted by 8/15 in a year when a Board proposal is required and transmitted, HHS is directed to implement the Board’s recommendations administratively.
  • Includes annual public report on system-wide health care costs, patient access to care, utilization and quality of care that allows for comparisons by region, types of services, types of providers and both private and Medicare.
  • Beginning 2015 and every 2 years thereafter, Board makes nonbinding recommendations on ways to slow national health spending (excluding recommendations for Medicare and other federal health programs). (PPACA §§ 3403, 10320)