Table 3

Three-year sequence of events

Determination year
 By 30 AprilChief Actuary of CMS makes projections and determination
 By 1 SeptemberDraft proposal sent by IPAB to MedPAC for consultation. Draft proposal sent by IPAB to Secretary for review and comment
Proposal year
 By 15 JanuaryProposal submitted by IPAB to Congress and the President
 By 25 JanuarySecretary submits own proposal to Congress and the President, with a copy to MedPAC, if IPAB was required to submit a proposal but failed to do so
 By 1 MarchSecretary submits report containing review and comments to Congress on IPAB proposal (unless the Secretary submitted own proposal because IPAB failed to do so)
 By 1 AprilDeadline for specified congressional committees to consider the submitted proposal and report out legislative language implementing the recommendations. Congress has the authority to develop its own proposal provided it meets the same fiscal requirements as established for the IPAB and meets this deadline.
 Beginning 15 AugustSecretary implements the proposal subject to exceptions
 On 1 OctoberRecommendations relating to fiscal year payment rate changes take effect
Implementation year
 On 1 JanuaryRecommendations relating to Medicare Part C and D payments take effect. Recommendations relating to calendar year payment rate changes take effect
  • IPAB, Independent Payment Advisory Board.

  • Source: CRS analysis of P.L. 111-148 as amended.1