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Advising the Congress on Medicare issues
MedPAC > Meetings > September 29-30, 2022

September 29-30, 2022

PUBLIC MEETING

MedPAC’s “October” 2022 public meeting (held this year in late September) was held virtually via video conference on the GoToWebinar platform.

Agenda

09/29/2022 . 10:00 am - 11:25 am

Supporting safety-net clinicians

Staff Contacts:

ISSUE:  The Medicare program strives to ensure access to care for all beneficiaries. However, some beneficiaries, such as those with low incomes, may have more difficulty accessing care. At the same time, some clinicians who treat high shares of low-income beneficiaries could experience financial strain, which may further undermine access to care or impact quality of care.

KEY POINTS: Policymakers may wish to consider options to better support safety-net clinicians.

ACTION:  Commissioners will provide feedback on the material and the direction of future analytical work.

09/29/2022 . 11:30 am - 12:30 pm

Mandated report: Evaluation of a prototype design for a post-acute care prospective payment system

Staff Contacts:

ISSUE:  The Consolidated Appropriations Act, 2021 requires MedPAC to design a prototype prospective payment system (PPS) for all post-acute care (PAC) providers and analyze the impacts of the prototype’s design. The report is due on June 30, 2023.

KEY POINTS: We will review the rationales for a PAC PPS, past Commission work and recommendations, and changes in the PAC landscape since the report was mandated. We will outline proposed work over the coming year.

ACTION:  Commissioners will discuss the planned work to meet the Congressional mandate.

09/29/2022 . 2:00 pm - 3:25 pm

Nursing facility staffing

Staff Contacts:

ISSUE:  The effects of the coronavirus pandemic on nursing facility residents and staff have renewed and intensified long-standing concerns about the adequacy of nursing home staffing.

KEY POINTS: This presentation will review federal and state nursing facility staffing requirements; and update the Commission on recent developments in CMS’s collection, reporting, and use of improved nursing staffing data.

ACTION:  Commissioners will discuss the material and provide guidance on future work.

09/29/2022 . 3:30 pm - 5:00 pm

Mandated report: Study on the expansion of telehealth

Staff Contacts:

ISSUE:  Historically, Medicare’s physician fee schedule has covered a limited set of telehealth services in rural locations. During the COVID-19 public health emergency (PHE), the Congress and CMS temporarily expanded Medicare’s coverage of telehealth services and increased payment rates for these services.

KEY POINTS: In the March 2021 report, the Commission presented a policy option for the Congress and CMS to temporarily continue some of the telehealth expansions to gather more evidence of their impact on access, quality, and cost. In the Consolidated Appropriations Act, 2022, the Congress extended Medicare’s telehealth flexibilities for 5 months (151 days) after the end of the PHE. The Congress also mandated that MedPAC submit a report by June 2023 on the utilization of telehealth services during the PHE and the impact of expanded telehealth coverage on access to care and quality.

ACTION:  Commissioners will discuss the material and provide guidance on future work.

09/30/2022 . 9:00 am - 10:30 am

Congressional request: Medicare and inpatient psychiatric facility care

Staff Contacts:

ISSUE:  In January 2022, the Chairman of the Committee on Ways and Means asked the Commission to conduct an analysis on the utilization and availability of mental health services for Medicare beneficiaries.

KEY POINTS: At this first in a series of presentations, we provide an overview of inpatient psychiatric facilities (IPFs) and Medicare’s payment system for IPF services, and report on trends in the supply and overall utilization of IPF services by Medicare beneficiaries, including enrollees in Medicare Advantage. We also present information on the quality of care in IPFs and IPFs’ costs and Medicare’s payments.

ACTION:  Commissioners will discuss the material.

09/30/2022 . 10:30 am - 12:00 pm

Analysis of Part D data on drug rebates and discounts

Staff Contacts:

ISSUE:  The Consolidated Appropriations Act, 2021, granted the Commission access to direct and indirect remuneration (DIR) data collected by CMS to administer the Medicare Part D program.

KEY POINTS:  Following on from presentations to the Commission at the October 2021 and April 2022 meetings, staff will describe its continued work evaluating DIR data.

ACTION:  Commissioners will provide feedback on the material and the direction of future analytical work.