CRS: Sebelius can take place of controversial Medicare board


But if Republican efforts to block the panel are effective, they could further empower Sebelius, the Congressional Research Service (CRS) said.

CRS said in a memo to Sen. Tom CoburnThomas (Tom) Allen CoburnThe Hill's Morning Report — Presented by PhRMA — Worries grow about political violence as midterms approach President Trump’s war on federal waste American patients face too many hurdles in regard to health-care access 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.