On July 29, 2009, the Energy and Commerce Committee of the U.S. House of Representatives returned to mark up after a brief recess. During the week-long recess, the Energy & Commerce leadership was negotiating with the conservative Democrats known as "Blue Dogs." Four of the seven Blue Dogs were satisfied with those negotiations, which meant that mark up could beginagain.
One of the main goals of healthcare reform is to reduce healthcare spending. In order to achieve this goal, the House of Representatives proposed to include “The Independent Medicare Advisory Council Act of 2009," a draft version of which was released July 17, 2009 by the Obama Administration into their health care reform legislation.
The Heart Rhythm Society and other medical societies expressed strong reservations with this proposal, concerned that it places Medicare reimbursement rate updates in the hand sof unelected officials. We strongly believe that Congress should continue to exert strong oversight over these critical programs and not inappropriately relegate these critical duties to an independent panel. We are also concerned that an independent panel will not have either the clinical expertise nor the research capacity to examine the national and regional effects of proposed recommendations to ensure patients are not unduly impacted.
However, this concern seems to have been addressed, as the IMAC proposal is supposed to be removed from the Energy and Commerce Committee version of the bill. The issue can still be raised in the Senate,. especially since President Obama is strongly advocating for this provision.
Background Information on the Proposal
The Independent Medicare Advisory Council Act of 2009 would create an Independent Medicare Advisory Council (IMAC) consisting of five members who are either physicians or have specialized expertise in medicine or health care policy. The members will be appointed by the President and confirmed by the Senate.
Beginning FY2015, IMAC would be charged with making annual recommendations to the President for changing payments update for various services covered by Medicare. Under the Administration’s proposal, each annual package of recommendations would have to be designed so that implementation would not be expected to increase aggregate Medicare spending over the subsequent 10-year period. Determination of the effect of the Council’s recommendations on net Medicare spending would be made by the Chief Actuary of the Centers for Medicare & Medicaid Services (CMS). In addition, the Council could make recommendations for reform of the Medicare delivery system. The President would have to approve or disapprove the Council’s recommendations as a package. If the President approved a set of recommendations, implementation would start no sooner than 30 days after that approval unless the Congress enacted a joint resolution to disapprove the package of recommendations. Under the proposed legislation, the first potential reductions in spending would not go into effect until fiscal year 2016.
According to the Congressional Budget Office (CBO), which provides economic analysis to Congress on proposed legislation, this proposal would save $2 billion over a 10 years period. This saving is a drop into a bucket compared to the $1 trillion price tag of the bill.
