HR Policy Association supports PPACA’s Independent Payment Advisory Board (IPAB) as a key cost control measure created to more effectively manage overall Medicare expenditures and promote payment reform to promote high quality, cost effective care.  After 2014, the IPAB will make recommendations to Congress to reduce Medicare costs if they are projected to grow too quickly.  Congress may reject the recommendations but the IPAB’s recommendations will be binding if Congress is unable to adopt an alternative means to reduce spending.  Unfortunately, the IPAB has been subjected to considerable scrutiny —including House passed repeal legislation—and it is yet another example of how the more beneficial aspects of PPACA aimed at controlling costs and improving quality have been subject to attack and drawn relatively limited support.