Limbaugh Claims Obama Granted A “Waiver” For IPAB Provisions

Limbaugh: Obama “Granted Another Waiver” To Seniors To “Keep Them Away From His IPAB Board.” From the April 20 edition of Premiere Radio Networks' The Rush Limbaugh Show:

LIMBAUGH: Obama's Medicare cuts, the death panels, the rationing, starts now. That's why the seniors in the USA Today story just previous to this were granted a waiver from it. Because it's drastic. It's rationing. And it wasn't supposed to happen till 2013. But now, you know, it's happening before the election. That's not the way it was supposed to happen. It's been elevated some -- or sped up. So here comes a waiver for the seniors.

[...]

LIMBAUGH: There's not one rules change under Paul Ryan. But under Obama, it's immediate. And not to be repetitive and redundant, but to be repetitive and redundant, it was just yesterday that Obama granted another waiver to senior citizens to keep them away from his IPAB board, who could have denied them coverage for -- just because they wanted to. [Premiere Radio Networks, The Rush Limbaugh Show, 4/20/11]

Waiver Deals With Medicare Advantage -- Not IPAB

AP: HHS Will Give “Quality Bonuses To Hundreds Of Medicare Advantage Plans Rated Merely Average.” From the Associated Press:

Millions of seniors in popular private insurance plans offered through Medicare will be getting a reprieve from some of the most controversial cuts in President Barack Obama's health care law.

In a policy shift critics see as political, the Health and Human Services department has decided to award quality bonuses to hundreds of Medicare Advantage plans rated merely average.

The $6.7 billion infusion could head off service cuts that would have been a headache for Obama and Democrats in next year's elections for the White House and Congress. More than half the roughly 11 million Medicare Advantage enrollees are in plans rated average.

[...]

The administration says the reason for the bonuses is quality improvement, not politics, and the program will be evaluated as it goes along.

“We are looking at whether an alternative payment incentive structure would lead to broader quality improvements across all Medicare Advantage plans, by giving incentives for a broader range of plans to improve,” said Medicare spokesman Brian Cook. [Associated Press, 4/19/11]

Limbaugh Says IPAB “Is The Death Panels” That Will “Ration” And Decide “Individual Cases”

Limbaugh: IPAB Will “Decide Who Gets Coverage And How Much Coverage Will Be Paid For.” From The Rush Limbaugh Show:

LIMBAUGH: Now, folks, you are going to be hearing -- IPAB, I-P-A-B, Independent Payment Advisory Board -- you're going to be hearing a lot more about IPAB in the days and weeks ahead. And I want to tell you today, April the 20th, what IPAB is. IPAB is the death panels. That's all you need to know, don't doubt me. IPAB is where the rationing will take place.

[...]

LIMBAUGH: Obama's Medicare cuts, the death panels, the rationing, starts now. That's why the seniors in the USA Today story just previous to this were granted a waiver from it. Because it's drastic. It's rationing. And it wasn't supposed to happen till 2013. But now, you know, it's happening before the election. That's not the way it was supposed to happen. It's been elevated some -- or sped up. So here comes a waiver for the seniors.

[...]

LIMBAUGH: These are the death panels. These are the people that are gonna decide who gets coverage and how much coverage will be paid for. Ergo the rationing. Congressional approval? There will be none. Whatever this board decides case by case happens by presidential fiat.

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LIMBAUGH: Forget everything you've heard about death panels. “Yes, they're in; no, they're not.” “We snuck them in; no, we got them out.” They're there. It's one. There is one death panel. It is IPAB. The Independent Payment Advisory Board. Current Medicare recipients, individual cases, decided on by these 15 people. Two things. Will there be coverage or not? And if so, how much will they be paid. [Premiere Radio Networks, The Rush Limbaugh Show, 4/20/11]

IPAB Is Prohibited From Rationing, Helps Medicare Stay Within Spending Limits

NEJM: Affordable Care Act “Establishes Specific Target Growth Rates For Medicare And Charges The IPAB With Ensuring That Medicare Expenditures Stay Within These Limits.” From The New England Journal of Medicine:

Provisions of the Patient Protection and Affordable Care Act (now being referred to as the Affordable Care Act, or ACA) create an Independent Payment Advisory Board (IPAB) to meet the need to oversee health care system costs. The legislation establishes specific target growth rates for Medicare and charges the IPAB with ensuring that Medicare expenditures stay within these limits. The IPAB must also make recommendations to Congress as to how to control health care costs more generally.

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The board is charged with developing specific detailed proposals to reduce per capita Medicare spending in years when spending is expected to exceed target levels, beginning with 2015. The DHHS must implement these proposals unless Congress adopts equally effective alternatives. The board is also charged with submitting to Congress annual detailed reports on health care costs, access, quality, and utilization. Finally, the IPAB must submit to Congress recommendations regarding ways of slowing the growth in private national health care expenditures. [New England Journal of Medicine, 5/26/10]

Kaiser: Board Cannot “Ration Care, Increase Taxes, Change Medicare Benefits Or Eligibility, Increase Beneficiary Premiums And Cost-Sharing Requirement, Or Reduce Low Income Subsidies Under Part D.” From KFF's “Explaining Health Reform: Medicare and the New Independent Payment Advisory Board”:

The Board is prohibited from submitting proposals that would ration care, increase taxes, change Medicare benefits or eligibility, increase beneficiary premiums and cost-sharing requirements, or reduce low-income subsidies under Part D. Prior to 2019, the Board is also prohibited from recommending changes in payments to providers and suppliers that are scheduled to receive a reduction in their payment updates in excess of a reduction due to productivity adjustments, as specified in the health reform law. The law establishes specific rules and deadlines for Congressional consideration of the Board's recommendations, and specific timelines and procedures for Congressional action on alternative proposals to achieve equivalent savings.[Kaiser Family Foundation, Explaining Health Reform: Medicare and the New Independent Payment Advisory Board, 04/10]