{
  "id": "R41511",
  "type": "CRS Report",
  "typeId": "REPORTS",
  "number": "R41511",
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  "source": "EveryCRSReport.com, University of North Texas Libraries Government Documents Department",
  "versions": [
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      "id": 419909,
      "date": "2013-04-17",
      "retrieved": "2016-04-06T23:30:15.791206",
      "title": "The Independent Payment Advisory Board",
      "summary": "In response, in part, to overall growth in Medicare program expenditures and growth in expenditures per Medicare beneficiary, the Patient Protection and Affordable Care Act (PPACA, P.L. 111-148, as amended) created the Independent Payment Advisory Board (IPAB, or the Board) and charged the Board with developing proposals to \u201creduce the per capita rate of growth in Medicare spending.\u201d The Secretary of Health and Human Services (the Secretary) is directed to implement the Board\u2019s proposals automatically unless Congress affirmatively acts to alter the Board\u2019s proposals or to discontinue the automatic implementation of such proposals. \nThe annual IPAB sequence of events begins each year, starting April 30, 2013, with the Chief Actuary of the Centers for Medicare & Medicaid Services calculating a Medicare per capita growth rate and a Medicare per capita target growth rate. If the Chief Actuary determines that the Medicare per capita growth rate exceeds the Medicare per capita target growth rate, the Chief Actuary would establish an applicable savings target\u2014the amount by which the Board must reduce future spending. This determination by the Chief Actuary also triggers a requirement that the Board prepare a proposal to reduce the growth in the Medicare per capita growth rate by the applicable savings target. The Board cannot ration care, raise premiums, increase cost sharing, or otherwise restrict benefits or modify eligibility. In generating its proposals, the Board is directed to consider, among other things, Medicare solvency, quality and access to care, the effects of changes in payments to providers, and those dually eligible for Medicare and Medicaid. If the Board fails to act, the Secretary is directed to prepare a proposal.\nBoard proposals must be submitted to the Secretary by September 1 of each year and to the President and Congress by January 15 of the following year. Board proposals are \u201cfast-tracked\u201d in Congress, and IPAB proposals go into force automatically unless Congress affirmatively acts to amend or block them within a stated period of time and under circumstances specified in the act. Section 3403(d) of the act establishes special \u201cfast track\u201d parliamentary procedures governing House and Senate committee consideration, and Senate floor consideration, of legislation implementing the Board or Secretary\u2019s proposal. These procedures differ from the parliamentary mechanisms the chambers usually use to consider most legislation and are designed to ensure that Congress can act promptly on the implementing legislation should it choose to do so. PPACA also established a second \u201cfast track\u201d parliamentary mechanism for consideration of legislation discontinuing the automatic implementation process for the recommendations of the Board.\nThe Board\u2019s charge is to develop proposals for the Secretary to implement that reduce the per capita growth in Medicare expenditures, not to reduce Medicare expenditures. Therefore, while the CBO projects that the cumulative impact of the Board\u2019s recommendations from 2015 through 2019 will reduce total spending by $15.5 billion, during the same period, Medicare expenditures will total $3.9 trillion with average spending per beneficiary forecast to increase from $13,374 to $15,749. While the Board\u2019s potential impact on total expenditures is likely to be relatively small compared to overall Medicare expenditures, its impact on particular Medicare providers or suppliers may be significant, particularly if the Board alters payment mechanisms. \nThe President\u2019s FY2013 budget, as submitted to Congress on February 13, 2012, includes a proposal to strengthen the IPAB. On March 22, 2012, the House passed a combined version of the Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011 (H.R. 5) that contained provisions from H.R. 452, the Medicare Decisions Accountability Act of 2011, which would repeal the IPAB.",
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      "topics": []
    },
    {
      "source": "University of North Texas Libraries Government Documents Department",
      "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc86569/",
      "id": "R41511_2012Mar12",
      "date": "2012-03-12",
      "retrieved": "2012-06-15T10:07:48",
      "title": "The Independent Payment Advisory Board",
      "summary": "In response, in part, to overall growth in Medicare program expenditures and growth in expenditures per Medicare beneficiary, the Patient Protection and Affordable Care Act created the Independent Payment Advisory Board (IPAB, or the Board) and charged the Board with developing proposals to \"reduce the per capita rate of growth in Medicare spending.\" This report discusses the responsibilities and duties.",
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      "topics": [
        {
          "source": "LIV",
          "id": "Medicare",
          "name": "Medicare"
        },
        {
          "source": "LIV",
          "id": "Health policy",
          "name": "Health policy"
        },
        {
          "source": "LIV",
          "id": "Medicaid",
          "name": "Medicaid"
        }
      ]
    },
    {
      "source": "University of North Texas Libraries Government Documents Department",
      "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc806006/",
      "id": "R41511_2010Nov30",
      "date": "2010-11-30",
      "retrieved": "2016-03-19T13:57:26",
      "title": "The Independent Payment Advisory Board",
      "summary": null,
      "type": "CRS Report",
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      "active": false,
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  "topics": [
    "Health Policy"
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}