IPAB
Your policy document mentioned “strengthening” the Independent Payment Advisory Board (IPAB). Do you recommend making all providers subject to IPAB cuts beginning in 2014?

To what degree do you expect your IPAB ideas will reduce Medicare spending by 2021, 2023, and the subsequent decade? What is the source of those estimates?

What specifically do you mean by “giving the IPAB additional tools to improve the quality of care while redcing costs, including allowing it to promote value-based benefits designs?” Would this require a statutory change given that IPAB is not currently allowed to consider changes to the Medicare benefit package?

Patient Safety
You touted an initiative your Administration rolled out on Monday to reduce hospital readmissions and hospital-acquired conditions. It appears as though this initiative is simply implementing provisions in the Democrats’ health care overhaul which the nonpartisan Congressional Budget Office estimates will reduce Meidcare spending by roughly $12 billion over the next decade. Yet your proposal claims this initiative will save $50 billion over this same time period. What is the source of this estimate and how would your proposal specifically change current law?

Medicare Part D
You propose limiting “excessive payments for prescription drugs by leveraging Medicare’s purchasing power” and prohibiting brand-name companies for entering into ‘pay for delay’ agreements with generic companies.” Which specific changes would you make to Medicare Part D and how much do you anticipate each change would save? Are you suggesting Medicaid-style rebates in Part D? If so, for which beneficiaries? Are you proposing repeal of the “non-interference” provision in Part D? You estimate your proposal would reduce Medicare spending by $200 billion over ten years? What is the basis for your savings estimates?

In order to meet our shared goal of keeping Medicare solvent for future generations by controlling spending, we intend to examine all proposals. We ask that you provide this additional clarification so that we can fully understand and evaluate the new Medicare proposals you have put forward. We thank you for your commitment to protecting Medicare for future generations and hope that you will work with us in the months ahead to achieve that goal.

Rep. Dave Camp (R-Mich.) is the chairman of the House Committee on Ways and Means. Rep. Fred Upton (R-Mich.) is the chairman of the House Committee on Energy and Commerce. The Chairmen share jurisdiction over the Medicare Program. This letter, dated April 20, 2011, was sent to President Obama and released Wednesday.