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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 (2)

The Congress should update the inpatient and outpatient payments by the amounts specified in current law

  • Hospital

March 2017

Inpatient rehabilitation facility services

The Congress should reduce the Medicare payment rate for inpatient rehabilitation facilities by 5 percent for fiscal year 2018. Additionally, the Commission reiterates its March 2016 recommendations on the inpatient rehabilitation facility prospective payment system.

  • Post-acute care

March 2017

Long-term care hospital services

The Congress should eliminate the update to the payment rates under the long-term care hospital prospective payment system for fiscal year 2018.

  • Post-acute care

March 2017

Outpatient dialysis services

The Congress should increase the outpatient dialysis base payment rate by the update specified in current law for calendar year 2018.

  • Ambulatory care settings

March 2017

Physician and other health professional services

The Congress should increase payment rates for physician and other health professional services by the amount specified in current law for calendar year 2018.

  • Physicians and other health professionals

March 2017

Skilled nursing facility services

The Congress should eliminate the market basket updates for 2018 and 2019 and direct the Secretary to revise the prospective payment system (PPS) for skilled nursing facilities. In 2020, the Secretary should report to the Congress on the impacts of the reformed PPS and make any additional adjustments to payments needed to more closely align… Read more »

  • Delivery system reforms
  • Post-acute care

March 2017

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