Part B Insider (Multispecialty) Coding Alert

The only thing standing between you and deep Medicare cuts may be your congressional representatives, and even that barrier may disappear by 2014.

That's the year the Independent Payment Advisory Board would replace the Medicare Payment Advisory Commission. The presidentially appointed 15-member IPAB, called "Super MedPAC" by some, will recommend cuts in Medicare payment rates.

The difference: If Congress doesn't vote either for or against IPAB's recommended cuts, the cuts would take effect.

In recent years, MedPAC has recommended steeper pay cuts than Congress has imposed. In an IPAB era, those steeper cuts could hit providers instead.

Unless: Rep. Phil Roe (R-Tenn.) and 23 other Republicans have introduced legislation to repeal the IPAB mandate. In introducing the Medicare Decisions Accountability Act (H.R. 452), Roe, who is a physician, said, "This board's sole purpose is to control Medicare costs -- giving this board the authority to approve and deny funding for care... My concern is that this board will harm patient care."

But getting rid of IPAB may get held up by political considerations. Republicans are launching their assault on the Affordable Care Act's entire health reform program by picking the most unpopular ACA provisions first, including IPAB. That may mean that the legislation will fail to garner necessary bipartisan support, even though many Democratic lawmakers are opposed to the board.