From MedPAC to IMAC: Obama would hand Medicare pay rate decisions to new independent council

The Obama administration has begun the process ofshifting control over Medicare rate adjustments for nursing homes, hospice andother providers away from Congress and toward a new, five-member independentexecutive agency, according to recent reports.

According to draft legislation being written by the WhiteHouse, the proposed agency, the Independent Medicare Advisory Council, wouldcomprise five president appointed, congressionally approved members, usuallyphysicians or others with special medical expertise, reports Politico.com. Theagency’s primary role would be to set payment rates for Medicare Part A andPart B, which it would do through issuance of two annual reports. Congresscould choose to block these proposals within 30 days, and the president wouldretain an up-or-down veto power over the agency, according to Politico. 

The Medicare Payment Advisory Commission currently actsonly as an advisory body to congress. In its most recent suggestion tocongress, MedPAC recommended freezing rates for skilled nursing facilities andcutting reimbursements to home health agencies by 5.5% (McKnight’s, 1/12). Bygiving a new commission authority to implement the changes it recommends, theWhite House could potentially damage the financial stability of SNFs and otherlong-term care agencies, long-term care provider advocates say.

For more on this topic, see our May 29 issue of TheEditors’ Blog.