CRS said in a memo to Sen. Tom CoburnTom CoburnDon't be fooled: Carper and Norton don't fight for DC Coburn: Trump's tweets aren't presidential The road ahead for America’s highways MORE (R-Okla.) that the law directs the HHS secretary to propose Medicare cuts if the IPAB doesn't.
Provisions of the law "create a requirement" that the secretary step in if the IPAB does not make recommendations, "regardless of the reason that the IPAB has not submitted a proposal within the required time frame," CRS said.
Coburn said the report makes clear that Sebelius could operate as an "IPAB of one."
The IPAB kicks in only if Medicare spending grows faster than a prescribed rate. The panel hasn't been created yet, but slow growth in Medicare spending means it wouldn't be triggered this year, anyway.
Technically, the IPAB would make recommendations to Congress. But those recommendations are designed to move on a "fast track." Congress doesn't have to approve the cuts — rather, they would take effect unless Congress blocks them and comes up with equivalent savings.
Cuts that came from Sebelius would move through the same expedited process, CRS said.