MedPAC’s October 2026 public meeting took place on Thursday, October 8th and Friday, October 9th. We had a limited number of seats available for in-person attendance at the Ronald Reagan Building and International Trade Center. The public was also welcome to view our meeting via live webcast. A public comment period was open to in-person attendees, and we will continue to publish any official comment letters received in response to the Commission’s discussion on our website.
The Horizon Ballroom
Ronald Reagan Building and International Trade Center
1300 Pennsylvania Avenue, NW Washington, DC 20004
Agenda
10/08/2026 . 11:00 am - 12:30 pm
Physician participation in Medicare Advantage provider networks: Comparing provider directories with encounter data
Staff Contacts:
ISSUE: Provider networks are a tool that Medicare Advantage (MA) plans use to manage care quality and cost for their enrollees. Beneficiaries rely on provider directories to determine the providers that are in their plan’s network.
KEY POINTS: In March 2026, commissioners reviewed preliminary analysis of clinician participation in MA networks using data from provider directories. An alternative approach to defining provider participation is to identify the providers that MA enrollees receive care from, as documented in MA encounter records. Commissioners expressed interest in learning about MA enrollees’ access to cancer care.
ACTION: Commissioners will review and discuss the material.
10/08/2026 . 12:30 pm - 12:45 pm
Public comment
Staff Contacts:
10/08/2026 . 2:00 pm - 3:20 pm
Issues affecting the payment accuracy of the physician fee schedule and the clinical laboratory fee schedule
Staff Contacts:
ISSUE: Medicare aims to establish accurate fee-for-service (FFS) payment rates. FFS Medicare uses different payment methodologies to set rates for different service lines. Medicare uses the Physician Fee Schedule (PFS) to set rates for clinician services and the Clinical Laboratory Fee Schedule (CLFS) for laboratory services.
KEY POINTS: The Commission has noted issues with the accuracy of PFS and CLFS payment rates.
ACTION: Commissioners will review and discuss the material.
10/08/2026 . 3:25 pm - 5:00 pm
Clinician quality initiatives in fee-for-service Medicare
Staff Contacts:
ISSUE: The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) created two FFS quality incentive programs for clinicians—an incentive payment for qualifying clinicians in advanced alternative payment models (A–APMs) and the Merit-based Incentive Payment System (MIPS) for clinicians not in A-APMs. The Commission has found MIPS to be overly burdensome and inequitable and in 2018 recommended that it be eliminated.
KEY POINTS: Measuring and paying for clinician quality in FFS Medicare continues to be challenging.
ACTION: Commissioners will review and discuss the material.
10/08/2026 . 5:00 pm - 5:15 pm
Public comment
Staff Contacts:
10/09/2026 . 9:00 am - 10:30 am
Medicare’s late-enrollment penalties
Staff Contacts:
ISSUE: Medicare requires certain beneficiaries to pay late-enrollment penalties if they do not enroll in Part B or Part D when they first become eligible.
KEY POINTS: Medicare’s late-enrollment penalties aim to discourage beneficiaries with relatively lower spending from delaying enrollment until they develop greater health care needs, but there are concerns that beneficiaries may inadvertently incur penalties due to the complexity of Medicare’s enrollment rules.
ACTION: As part of ongoing work on the complexity of the enrollment decisions facing Medicare beneficiaries, commissioners will review the materials and discuss next steps.
10/09/2026 . 10:35 am - 11:35 am
Workplan: Assessing the accuracy of the skilled nursing facility and home health prospective payment systems
Staff Contacts:
ISSUE: In 2019 and 2020, CMS implemented major revisions to FFS Medicare’s skilled nursing facility and home health prospective payment systems.
KEY POINTS: Understanding the accuracy of these new payment systems is important both to ensure beneficiary access to care and to evaluate program (and taxpayer) spending.
ACTION: Commissioners will review and discuss the workplan.
10/09/2026 . 11:35 am - 11:50 am
Public comment
Staff Contacts: