Bipartisan Senate Budget Agreement Reached, Includes IPAB Repeal

On Wednesday, February 7, the U.S. Senate reached an agreement to fund the government through March 23 that also includes several provisions related to ASA priorities.  Both the U.S. Senate and U.S. House must vote on the agreement before it can be sent to the President.  Funding for the federal government is due to expire on Thursday, February 8, without further action by Congress. 

ASA is very pleased that in this deal, the Independent Payment Advisory Board (IPAB) would be repealed.  ASA has been a strong opponent of IPAB, a board of 15 non-elected and unaccountable appointees with sweeping powers to mandate across-the-board payment or other targeted reductions in Medicare Part B payments.  The board’s cuts would have disproportionately fallen on physicians, as some providers, including hospitals and hospice care, are exempt from IPAB cuts until 2020. Thus, along with the already unreasonably low Medicare payments for anesthesia services (“the 33 percent problem”), IPAB cuts would have disproportionately impacted physician anesthesiologists specifically.

ASA was a co-founder, along with the American College of Neurological Surgeons, of the IPAB Repeal Coalition, which consisted of over twenty specialty physician organizations representing more than 350,000 physicians and their patients. The coalition has supported a number of legislative efforts to repeal IPAB. In November, a bill to repeal IPAB passed in the House of Representatives but had not been advanced in the Senate.

The Senate agreement also includes provision to extend the work geographic practice cost index (GPCI) floor.

Funding to address the ongoing opioid abuse epidemic is also included in the funding bill.  ASA is pleased that $3 billion is included for Fiscal Year 2018 and $3 billion for Fiscal Year 2019 to address the substance abuse epidemic.  Additionally, this agreement includes a $2 billion increase for the National Institutes of Health (NIH) over two years.

Less favorably, the package includes language that reduces the annual MACRA-mandated .5% physician fee schedule update to a .25% update in 2019.

ASA is currently reviewing other provisions within the agreement and will provide additional information as the agreement is finalized.