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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
Skilled nursing facility services The Congress should eliminate the update to payment rates for skilled nursing facility services for fiscal year 2011.	Post-acute care	March 2010
Home health services (1) The Congress should eliminate the market basket increase for 2010 and advance the planned reductions for coding adjustments in 2011 to 2010, so that payments in 2010 are reduced by 5.5 percent from 2009 levels.	Post-acute care	February 2009
Home health services (2) The Congress should direct the Secretary to rebase rates for home health care services in 2011 to reflect the average cost of providing care.	Post-acute care	February 2009
Home health services (3) The Congress should direct the Secretary to assess payment measures that protect the quality of care and ensure incentives for the efficient delivery of home health care. The study should include alternative payment strategies such as blended payments and risk corridors and outcome-based quality incentives.	Delivery system reforms Post-acute care Quality	February 2009
Inpatient rehabilitation facility services The update to the payment rates for inpatient rehabilitation facility services should be eliminated for fiscal year 2010.	Post-acute care	February 2009
Long-term care hospital services The Secretary should update payment rates for long-term care hospitals for fiscal year 2010 by the projected rate of increase in the rehabilitation, psychiatric, and long-term care hospital market basket index less the Commission’s adjustment for productivity growth.	Post-acute care	February 2009
Reforming Medicare’s hospice benefit (1) The Congress should direct the Secretary to change the Medicare payment system for hospice to: * Have relatively higher payments per day at the beginning of the episode and relatively lower payments per day as the length of the episode increases, * Include a relatively higher payment for the costs associated with patient death at… Read more »	Post-acute care	February 2009
Reforming Medicare’s hospice benefit (2A) The Congress should direct the Secretary to: * Require that a hospice physician or advanced practice nurse visit the patient to determine continued eligibility prior to the 180th-day recertification and each subsequent recertification and attest that such visits took place, * Require that certifications and recertifications include a brief narrative describing the clinical basis for… Read more »	Beneficiaries and coverage Post-acute care	February 2009
Reforming Medicare’s hospice benefit (2B) The Secretary should direct the Office of Inspector General to investigate: * The prevalence of financial relationships between hospices and long-term care facilities such as nursing facilities and assisted living facilities that may represent a conflict of interest and influence admissions to hospice, * Differences in patterns of nursing home referrals to hospice, * The… Read more »	Post-acute care	February 2009
Reforming Medicare’s hospice benefit (3) The Secretary should collect additional data on hospice care and improve the quality of all data collected to facilitate the management of the hospice benefit. Additional data could be collected from claims as a condition of payment and from hospice cost reports.	Post-acute care	February 2009