Three-year sequence of events
| Determination year | |
| By 30 April | Chief Actuary of CMS makes projections and determination |
| By 1 September | Draft proposal sent by IPAB to MedPAC for consultation. Draft proposal sent by IPAB to Secretary for review and comment |
| Proposal year | |
| By 15 January | Proposal submitted by IPAB to Congress and the President |
| By 25 January | Secretary 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 March | Secretary 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 April | Deadline 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 August | Secretary implements the proposal subject to exceptions |
| On 1 October | Recommendations relating to fiscal year payment rate changes take effect |
| Implementation year | |
| On 1 January | Recommendations 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