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Can the IPAB refuse to cover care that isn’t ‘cost-effective?’

  • May 1, 2013

Q. I’ve heard that the goal of IPAB is to save money, and that it will refuse to cover care that isn’t “cost-effective.” Is this true?

A. No. The Affordable Care Act is explicit: IPAB cannot make recommendations that “ration care, raise beneficiary premiums or cost-sharing, reduce benefits, or change eligibility for Medicare.” What it can do is reduce payment for treatments that medical evidence shows are not effective.

Read more FAQs about health reformMedicare and the IPAB.