MedPAC’s September 2025 public meeting will be available via live webcast.
There are three separate sessions as indicated below. Given the limited number of registrants for each session, we request that you only sign up for the sessions you are able to attend.
Register for the Friday, September 5 session (9:00AM to 12:00PM) by clicking here
Topics covered: Access to hospice and certain services under the hospice benefit for beneficiaries with end-stage renal disease or cancer; The association between changes in Medicare Advantage enrollment and hospital finances
Agenda
09/04/2025 . 10:15 am - 11:30 am
Medicare payment operations and improving payment accuracy
Staff Contacts:
ISSUE: At the April 2025 meeting, commissioners expressed interest in learning more about Medicare’s claims processing operations and the role of Medicare administrative contractors (MACs) in helping to ensure that Medicare’s payments are proper.
KEY POINTS: Due to checks built into Medicare’s claims processing system, the majority of Medicare payments are made properly. However, because of the sheer size of Medicare spending, a relatively small share of payments being made improperly can amount to tens of billions of dollars, making this an important issue for the program.
ACTION: This presentation is intended as a companion to the Comptroller General’s session to follow. Commissioners will review and discuss the material on Medicare’s payment operations and program integrity efforts.
09/04/2025 . 11:45 am - 12:45 pm
Oversight needed to ensure Medicare’s sustainability: A report from the Government Accountability Office
Staff Contacts:
ISSUE: The U.S. Government Accountability Office (GAO) has repeatedly cautioned that the Medicare program, which processes over a billion transactions each year, is susceptible to improper payments, as well as to potential mismanagement and fraud, waste, and abuse.
KEY POINTS: The Comptroller General of the United States will join commissioners to discuss GAO’s work related to improper payments in the Medicare program and opportunities to improve program sustainability.
ACTION: Commissioner discussion may inform future work on this topic.
09/04/2025 . 2:15 pm - 4:15 pm
Context for Medicare payment policy
Staff Contacts:
ISSUE: Each year in our March report to the Congress, we describe Medicare’s overall financial situation and factors contributing to Medicare’s spending growth.
KEY POINTS: The “Context” chapter outlines the factors contributing to Medicare’s spending growth and other issues and is meant to serve as a backdrop for commissioners’ discussions and recommendations over the coming year.
ACTION: Commissioners will review and discuss the material.
09/05/2025 . 9:00 am - 10:30 am
Access to hospice and certain services under the hospice benefit for beneficiaries with end-stage renal disease or cancer
Staff Contacts:
ISSUE: The Medicare hospice benefit covers palliative and support services for terminally ill beneficiaries with a life expectancy of six months or less. When a beneficiary chooses to enroll in the hospice benefit, the hospice provider assumes all financial risk for costs and services that are reasonable and necessary for palliation of the patient’s terminal illness and related conditions. Concerns have been raised about whether Medicare payment serves as a barrier to hospice care for certain beneficiaries for whom high-cost services might be palliative—specifically, dialysis for beneficiaries with ESRD and radiation, blood transfusions, and chemotherapy for beneficiaries with cancer.
KEY POINTS: At the April 2025 commission meeting, staff presented initial results from an analysis of claims data that showed less hospice use and/or shorter stays among beneficiaries with ESRD and those with blood cancer. We also reported findings from interviews with clinicians, hospice providers, and family members of hospice patients that suggested that the hospice payment system may create a disincentive for hospices to furnish certain high-cost services that may be palliative for some patients, which in turn may lead some beneficiaries who wish to enroll in hospice to choose not to do so or to do so only in the last days of life.
ACTION: Commissioners will review findings from new analyses and discuss directions for future work.
09/05/2025 . 10:35 am - 12:00 pm
The association between changes in Medicare Advantage enrollment and hospital finances
Staff Contacts:
ISSUE: Medicare Advantage (MA) has been growing rapidly and now covers more than half of eligible beneficiaries. As a result, MA enrollees now comprise a substantial share of many providers’ patients and revenues. Some hospital groups have stated that MA growth has been challenging for them, operationally and financially. However, there is limited data quantifying how MA growth has affected the finances of different types of hospitals.
KEY POINTS: In April 2025, staff presented findings from an analysis of the relationship between the recent growth in Medicare Advantage (MA) enrollment and rural hospitals’ finances. In that analysis, we found no statistically significant effect, on average, of MA enrollment on rural hospitals’ revenue, costs, or profit margins.
ACTION: Commissioners will review and discuss findings from an analysis of the relationship between growth in MA and urban and rural hospitals’ finances.