Legislation to Extend Independence at Home Program and Repeal IPAB Advance in Congress

Recent votes in the House of Representatives have allowed bills to extend the Independence at Home (IAH) demonstration and repeal the Independent Payment Advisory Board (IPAB) to advance through committees and be considered by the full House.

As part of the Children’s Health Insurance Program (CHIP) mark-up held recently by the House of Representatives Energy and Commerce Committee, legislation extending the Independence at Home demonstration program was voted on and approved by the committee.

When originally created, this program sought out to provide robust and comprehensive primary care services to patients in their home. Additionally, the program was designed to test if hospitalizations were reduced, improve patient satisfaction and health while decreasing costs to the Medicare program. Originally drafted as a five-year program, years one and two demonstrate that those goals are being met — patients have been very satisfied with the care they receive, and saving have been realized. In year two, the 15 participating providers collectively saved over $10 million, according to a Centers for Medicare and Medicaid Services (CMS) study. Under this legislation, the Independence at Home program will be extended an additional two years, and the number of allowable beneficiaries will increase from 10,000 to 15,000.

The House’s Ways and Means Committee held a mark-up and vote regarding the repeal of the Independent Payment Advisory Board (IPAB). Created under the Affordable Care Act, the IPAB is a yet to be established 15 member committee that would have the authority to recommend cost cuts to Medicare that go into effect automatically should certain financial projections be met. Congress would have no authority to override what the IPAB recommends, unless they come up with an alternative that saves an equal amount of money. Naturally, the IPAB has been controversial since its creation and has not yet been filled with board members. Put into practical perspective, if the IPAB board were triggered, our industries would be facing a fight against budget cuts similar to the Home Health Groupings Model on a yearly basis.

Both bills are now eligible to be considered on the floor of the House or Representatives. The Independence at Home program was extended in the Senate as part of the CHRONIC Care Act, but will likely need to be reconsidered, or included in another legislative package, as the House is not expected to put CHRONIC Care up for a vote. Additionally, the Senate has yet to act on the IPAB, but may also be included in their CHIP considerations. Its elimination has been supported by Senate leaders such as Majority Whip John Cornyn (R-TX) and and Senator Ron Wyden (D-OR), the Ranking Member of the Finance Committee.

Stay tuned to NAHC Report for updates on the progress of this legislation.