New Entities Created Pursuant to the Patient Protection and Affordable Care Act

“The precise number of new entities that will ultimately be created pursuant to PPACA is currently unknowable, for the number of entities created by some sections is contingent upon other factors, and some new entities may satisfy more than one requirement in the legislation. Although PPACA states that certain entities were ‘established’ by the legislation, in practical terms, these entities will not be able to function until members are appointed and appropriations are provided or made available… The degree of specificity in these provisions may have implications for congressional control and, conversely, the amount of discretion that agencies will have in the implementation of the legislation. PPACA significantly increased the appointment responsibilities of the Comptroller General of the United States, and it is unclear how the Government Accountability Office (GAO) will be able to independently audit entities whose members are appointed by the head of GAO.”