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Among the group’s primary concerns is that practicing doctors will be excluded from the law’s treatment-recommendation panel and that the new Independent Payment Advisory Board wields too much power and will make decisions based exclusively on cost.

“We’re worried about the [payment] board making decisions without considering a patient’s access to care and the effectiveness of care,” said Dr. Laxmaiah Manchikanti, chairman of the American Society of Interventional Pain Physicians.

The 18-member board, include 15 full-time members, will make recommendations on Medicare and other health care costs without congressional approval. For example, the recommendations go into effect if Congress votes against them, but the president vetoes the vote and Congress cannot get the two-thirds majority vote to overturn the veto.

“We’ll have no recourse in Congress,” Dr. Manchikanti said.

In group’s joint-effort with the North American Neuromodulation Society, nearly 200 doctors came to Capitol Hill to call upon such top Republican Party lawmakers as Louisiana Sen. David Vitter and Minnesota Rep. Michele Bachmann.

However, the most solid promise Tuesday perhaps came from Sen. Sherrod Brown, a Ohio Democrat who voted for the multi-billion dollar reform legislation.

Mr. Brown vowed to circulate a petition asking the House and Senate to put working doctors on the treatment board, officially known as the Patient Centered Outcomes Research Institute. The 40-member nonprofit includes the National Institutes of Health director and 17 appointees by the General Accounting Office.

“A letter doesn’t get it accomplished, but it’s a start,” said Dr. David S. Kloth, a Connecticut doctor and ASIPP director.