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Advising the Congress on Medicare issues
MedPAC > Recommendations

Commission Recommendations

MedPAC makes recommendations to the Congress and to the Secretary of Health and Human Services on issues affecting the administration of the Medicare program. With its recommendations, the Commission strives to improve the delivery of care, while ensuring financial stability and maximizing value for the program. After extensive analysis and evaluation, our recommendations are discussed and voted on by Commissioners in our public meetings. Recommendations are typically published in two main reports, released in March and June of each year.

Recommendations Topic(s) Date

Hospital inpatient and outpatient services

For fiscal year 2023, the Congress should update the 2022 Medicare base payment rates for acute care hospitals by the amount specified in current law.

  • Hospital

March 2022

Improving Medicare’s policies for separately payable drugs in the hospital outpatient prospective payment system (1)

The Congress should direct the Secretary to modify the pass-through drug policy in the hospital outpatient prospective payment system so that it: includes only drugs and biologics that function as supplies to a service and applies only to drugs and biologics that are clinically superior to their packaged analogs.

  • Drugs, Devices, and Tests
  • Hospital

June 2021

Improving Medicare’s policies for separately payable drugs in the hospital outpatient prospective payment system (2)

The Secretary should specify that the separately payable non-pass-through policy in the hospital outpatient prospective payment system applies only to drugs and biologics that are the reason for a visit and meet a defined cost threshold.

  • Drugs, Devices, and Tests
  • Hospital

June 2021

Revising Medicare’s indirect medical education payments to better reflect teaching hospitals’ costs

The Congress should require CMS to transition to empirically justified indirect medical education adjustments to both inpatient and outpatient Medicare payments.

  • Hospital

June 2021

Hospital inpatient and outpatient services

For fiscal year 2022, the Congress should update the 2021 Medicare base payment rates for acute care hospitals by 2 percent.

  • Hospital

March 2021

Hospital inpatient and outpatient services

The Congress should: For 2021, update the 2020 Medicare base payment rates for acute care hospitals by 2 percent; and Provide hospitals with an amount equal to the difference between the update recommendation and the amount specified in current law through the Commission’s recommended hospital value incentive program (HVIP)

  • Hospital
  • Quality

March 2020

Options for slowing the growth of Medicare fee-for-service spending for emergency department services

The Secretary should develop and implement a set of national guidelines for coding hospital emergency department visits under the outpatient prospective payment system by 2022.

  • Hospital

June 2019

Hospital inpatient and outpatient services

The Congress should: Replace Medicare’s current hospital quality programs with a new hospital value incentive program (HVIP) that: includes a small set of population-based outcome, patient experience, and value measures; scores all hospitals based on the same absolute and prospectively set performance targets; accounts for differences in patients’ social risk factors by distributing payment adjustments… Read more »

  • Hospital
  • Quality

March 2019

Using payment to ensure appropriate access to and use of hospital emergency department services (1)

The Congress should: allow isolated rural stand-alone emergency departments (more than 35 miles from another emergency department) to bill standard outpatient prospective payment system facility fees and provide such emergency departments with annual payments to assist with fixed costs.

  • Hospital

June 2018

Using payment to ensure appropriate access to and use of hospital emergency department services (2)

The Congress should reduce Type A emergency department rates by 30 percent for off-campus stand-alone emergency departments that are within six miles of an on-campus hospital emergency department.

  • Hospital

June 2018