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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

Status report on the Medicare Advantage program

The Secretary should calculate Medicare Advantage benchmarks using fee-for-service spending data only for beneficiaries enrolled in both Part A and Part B.

  • Part C (Medicare Advantage)

March 2017

Improving Medicare Part D (1)

The Congress should change Part D to: transition Medicare’s individual reinsurance subsidy from 80 percent to 20 percent while maintaining Medicare’s overall 74.5 percent subsidy of basic benefits, exclude manufacturers’ discounts in the coverage gap from enrollees’ true out-of-pocket spending, and eliminate enrollee cost sharing above the out-of-pocket threshold.

  • Beneficiaries and coverage
  • Drugs, Devices, and Tests

June 2016

Improving Medicare Part D (2)

The Congress should change Part D’s low-income subsidy to: modify copayments for Medicare beneficiaries with incomes at or below 135 percent of poverty to encourage the use of generic drugs, preferred multisource drugs, or biosimilars when available in selected therapeutic classes; direct the Secretary to reduce or eliminate cost sharing for generic drugs, preferred multisource… Read more »

  • Beneficiaries and coverage
  • Drugs, Devices, and Tests

June 2016

Improving Medicare Part D (3)

The Secretary should change Part D to: remove antidepressants and immunosuppressants for transplant rejection from the classes of clinical concern, streamline the process for formulary changes, require prescribers to provide standardized supporting justifications with more clinical rigor when applying for exceptions, and permit plan sponsors to use selected tools to manage specialty drug benefits while… Read more »

  • Drugs, Devices, and Tests

June 2016

Mandated report: Developing a unified system for post-acute care

The Commission has voted to forward to the Congress the report on the unified post-acute care payment system required by the Improving Medicare Post-Acute Care Transformation Act of 2014.

  • Post-acute care

June 2016

Medicare Part B drug and oncology payment policy issues

The Secretary should reduce the Medicare Part B dispensing and supplying fee to rates similar to other payers.

  • Drugs, Devices, and Tests

June 2016

Ambulatory surgical center services

The Congress should eliminate the update to the payment rates for ambulatory surgical centers for calendar year 2017. The Congress should also require ambulatory surgical centers to submit cost data.

  • Ambulatory care settings

March 2016

Home health care services

The Congress should direct the Secretary to eliminate the payment update for 2017 and implement a two-year rebasing of the payment system beginning in 2018 for home health care services. The Congress should direct the Secretary to revise the prospective payment system to eliminate the use of therapy visits as a factor in payment determinations,… Read more »

  • Post-acute care

March 2016

Hospice services

The Congress should eliminate the update to the hospice payment rates for fiscal year 2017.

  • Post-acute care

March 2016

Hospital inpatient and outpatient services

The Congress should direct the Secretary of the Department of Health and Human Services to: update inpatient and outpatient payments by the amount specified in current law; reduce Medicare payment rates for 340B hospitals’ separately payable Part B drugs by 10 percent of the average sales price; direct the program savings from reducing Part B… Read more »

  • Drugs, Devices, and Tests
  • Hospital

March 2016