Update X2: If the Executive Branch gets control of MedPAC, then what happens.

I’ve emailed a source for an answer to this question:

Now that the healthcare bill has passed the House onto the Senate, what intentions/implications of the MedPAC reform bill (S. 1110) can be inferred.  Specifically, the authority given to the executive branch (from the legislative branch) to set Medicare fee schedules, covered service, etc..

UNDERSTAND RS readers:  That in healthcare, the Medicare fee schedule is used to base reimbursements to doctors for auto and workman’s comp insurances–the executive branch would reach directly into those insurance industries at the state level.  This could be construed as the final nail in the insurance industry coffin with the White House dictating Medicare.  Literally.

Read on for the full story.

 A little-known bill S. 1110, written by John Rockefeller (D-WV) sits in the Senate Finance Committee. This particular Senate bill according to the Congressional Research Service is summarized as:

Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009:

Amends title XVIII (Medicare) of the Social Security Act to rename the Medicare Payment Advisory Commission (MedPAC) the Medicare Payment and Access Commission, make it an independent executive branch (instead of a legislative branch) agency, and revise its membership requirements. Directs MedPAC to determine payment rates for items and services furnished under Medicare. Requires the Comptroller General to study and report annually to Congress on changes to payment policies under the Medicare program as a result of the amendments made by this Act. Makes it in order in the Senate or the House to consider any measure that would overrule a MedPAC determination with respect to such payments if three-fifths of the Members agree to such consideration. Authorizes MedPAC to advise the Secretary of Health and Human Services (HHS), through the Director of the Agency for Healthcare Research and Quality and the Director of the National Institutes of Health (NIH), on priorities for health services research. Directs MedPAC to establish: (1) an office of ombudsman to handle complaints on the implementation of certain regulations; and (2) a council of health and economic advisers to advise it on its development, analyses, and implementation of payment policies. Establishes: (1) a consumer advisory council to advise MedPAC on the impact of Medicare payment policies on consumers; and (2) a federal health advisory council.

This appears to be a power grab by Obama to further control the healthcare system. Why else would he want to transfer power from the legislative branch to the executive branch.

You just have to ask yourself, why?

Update: Congressman Mike Pence, Chairman of the GOP Conference clearly understands the implications of this bill.  Pence sums it up succinctly:

Both bills would empower boards to make recommendations on reductions in Medicare payment levels—the White House bill through its new Council, and the Rockefeller bill through a revampedMedicare Payment Advisory Commission (MedPAC).
• Both bills would give the President the power to appoint board members, subject to Senate confirmation; MedPAC members are currently appointed by the Comptroller General, but S. 1110 would make the Commission an independent executive branch agency, with its members subject to Presidential appointment.

• Both bills would make the boards’ recommendations binding absent external action. The Rockefeller bill would permit Congress to overrule recommendations made by the Commission—but only if 3/5 of Members in each chamber agreed to consider such legislation. The White House proposal would require the President to give his up-or-down approval of the Council’s recommendations en bloc, andif the President approves, Congress would have 30 legislative days to pass a joint resolution expressing its disapproval—otherwise the proposals would be implemented.

• Both bills would give the respective commissions the power to set reimbursement rates for providersin Medicare. Some Members may be concerned that these provisions could result in the federalgovernment refusing to reimburse doctors and hospitals for providing treatments to seniors that, while effective, are too costly.

• While press reports indicate that some Democrat Members are insisting on higher Medicarere imbursements for rural areas to expand physician access in those locales, there is nothing ineither proposal that would prohibit the respective councils from reducing—or even eliminating entirely—these payment increases for rural providers.

• The White House bill would go further than the Rockefeller proposal, empowering the new IMAC to impose “delivery system reforms” on health care providers. Page 11 of the bill notes that such reforms must “either improve the quality of medical care received by the beneficiaries of the Medicare program or improve the efficiency of the Medicare program’s operation.” Some Members may be concerned that this provision, by allowing the enactment of “reforms” that EITHER improve beneficiary care OR save the program money could result in this new board of bureaucrats denying access to life-saving treatments on cost grounds.

• Both pieces of legislation would also place significant restrictions on judicial review that would effectively prohibit individuals harmed by the boards’ recommendations—including any seniors denied access to care because of a bureaucratic prohibition on covering costly treatments. “In health care, waiting lines…can reduce the average cost of health capital, even while raising patient costs in terms of time and inconvenience. Health care waiting lines represent a trade-off between patient costs and capital costs.”— Senior Obama Administration Official Sherry Glied, writing in Critical Condition: Why Health Reform Fails

• Because both pieces of legislation would give the President veto power over any disapproval resolution, overriding the recommendations of the respective Commissions could effectively require the support of 2/3 of Congress—which would give the bureaucratic boards significant leverage to make binding decisions on millions of doctors and other health care professionals.

• Some Members may believe that both proposals resemble a concept advocated by former Senator Tom Daschle—a board of unelected bureaucrats making health care decisions, including decisions about which therapies and treatments the federal government will cover. In his book Critical,Daschle wrote that, “We won’t be able to make a significant dent in health-care spending without getting into the nitty-gritty of which treatments are the most clinically valuable and cost-effective.” Given the various proposals for a “MedPAC on steroids,” some Members may be concerned by the implications of these potential changes—which would give unelected and unaccountable bureaucrats power to micro-manage the doctor-patient relationship and deny life-saving treatments to millions ofAmerican seniors. Moreover, some Members may view the many new bureaucracies the bill establishes—and the significant powers given to them—as emblematic of the many problems associated with the Democrat-proposed government takeover of the health care system.

Read Pence’s entire report here.

Clearly, there are many problems with this “reform.”