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Beginning inthe Chief Actuary of the Centers for Medicare and Medicaid Services determine in particular years the projected per capita growth rate for Medicare for a multi-year period ending in the second year thereafter the "implementation year". If the projection exceeds a target growth rate, IPAB must develop a proposal to reduce Medicare spending in the implementation year by a specified amount.
If it is required to develop a proposal, the Board must submit that proposal in of the year before the implementation year; thus, the first proposal could be submitted in to take effect in. If the Board fails to submit a proposal that the Chief Actuary certifies achieve the savings target, the Secretary of Health and Human Services must submit a proposal that achieve that amount of savings. The Secretary must then implement the proposal unless Congress enacts resolutions made to override the Board's or the Secretary's decisions under a fast-track procedure that the law sets forth.
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