SUBJECT: Repeal IPAB, Pass H.R. 849, the Protecting Seniors’ Access
to Medicare Act
Dear Chairman Brady and Ranking Member Neal:
On behalf of the American Association of Neurological Surgeons (AANS) and the Congress of
Neurological Surgeons (CNS), we urge you to favorably report out the Protecting Seniors’ Access to
Medicare Act, H.R. 849, without amendment or offsets when the Ways and Means Committee takes up
the bill at tomorrow’s markup. As you know, H.R. 849 would repeal the Independent Payment Advisory
Board (IPAB), which is charged with making steep cuts to the Medicare program; thus adversely
affecting seniors’ ability to see their trusted physicians and get the care they need when they need it.
From the beginning of Medicare, members of Congress have played an essential role in shaping policies
that best meet the needs of their communities and constituents to ensure that the health care system is
equipped to care for diverse populations across the country. With the advent of the IPAB, however, the
people’s elected representatives will no longer have power over Medicare payment policy. Instead,
these major health policy decisions will rest in the hands of 15 unelected and largely unaccountable
individuals. Even worse, if IPAB fails to report recommendations or never becomes operational, this
power will rest solely in the hands of a single person — the Secretary of the Department of Health and
Human Services. Not only does the creation of IPAB severely limit congressional authority, but it also
eliminates the transparency of hearings, debate and a meaningful opportunity for critical stakeholder
input. Furthermore, IPAB decisions are not subject to judicial review, granting the board even more
unprecedented powers.
While we recognize the need to reduce the federal budget deficit and control the growth of health care
spending, the IPAB is simply the wrong solution for addressing these budgetary challenges. With the
advent of the Medicare Access and CHIP Reauthorization Act (MACRA) and other value-based payment
programs, physicians are working to improve health care quality and drive down Medicare costs.
However, rather than this thoughtful approach to cost containment and quality improvement to enhance
the value of the Medicare program, the IPAB is merely a blunt instrument to reduce what Medicare pays
for medical treatments and will bring progress on value-based care to a screeching halt.
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Read full letter here
