[Congressional Record Volume 156, Number 47 (Wednesday, March 24, 2010)]
[Extensions of Remarks]
[Page E473]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                       RECONCILIATION ACT OF 2010

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                               speech of

                        HON. ALLYSON Y. SCHWARTZ

                            of pennsylvania

                    in the house of representatives

                         Sunday, March 21, 2010

  Ms. SCHWARTZ. Mr. Speaker, I, on behalf of myself and Mr. Neal, rise 
to speak about the Independent Payment Advisory Board (IPAB), which is 
a new executive branch entity created in the Senate passed health 
reform bill, H.R. 3590, the Patient Protection and Affordable Care Act.
  In particular I want to clarify legislative intent with regard to one 
issue in IPAB. Section 1899A(c)(2)(A)(iii) of the Social Security Act, 
as added by Section 3403 of PPACA, states that in the case of IPAB 
proposals submitted prior to December 31, 2018, IPAB shall not include 
any recommendations that would reduce payment rates for providers that 
receive an additional market basket cut on top of the productivity 
adjustment. The rationale for this provision is that these providers 
are already facing extra downward adjustments in their payments and 
thus should not be subject to ``double jeopardy'' by also being subject 
to IPAB recommendations which will further reduce spending.
  In creating this exclusion, it is the intent of Congress to exclude 
all payment reductions applicable to providers captured by this 
language in all the relevant years. Therefore, in the case of inpatient 
hospitals, the provision excludes from IPAB recommendations payment 
reductions applicable to hospitals including payment reductions for 
indirect medical education under 1886(d)(5)(B), graduate medical 
education under 1886(h), disproportionate share hospital payments under 
1886(d)(5)(F), and capital payments, as well as incentives for adoption 
and maintenance of meaningful use of certified electronic health record 
technology under 1886(n).
  In addition, further clarifications are needed to ensure that IPAB is 
empowered to recommend payment improvements for all items and services 
provided to Medicare beneficiaries.

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