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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
Inpatient rehabilitation facility services (1) The Congress should eliminate the update to the Medicare payment rate for inpatient rehabilitation facilities in fiscal year 2017.	Post-acute care	March 2016
Inpatient rehabilitation facility services (2) The Secretary should conduct focused medical record review of inpatient rehabilitation facilities that have unusual patterns of case mix and coding.	Post-acute care	March 2016
Inpatient rehabilitation facility services (3) The Secretary should expand the inpatient rehabilitation facility outlier pool to redistribute payments more equitably across cases and providers.	Post-acute care	March 2016
Long-term care hospital services The Secretary should eliminate the update to the payment rates for long-term care hospitals for fiscal year 2017.	Post-acute care	March 2016
Outpatient dialysis services The Congress should increase the outpatient dialysis base payment rate by the update specified in current law for calendar year 2017.	Ambulatory care settings	March 2016
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 2017.	Physicians and other health professionals	March 2016
Skilled nursing facility services The Congress should eliminate the market basket update for skilled nursing facilities for fiscal years 2017 and 2018 and direct the Secretary to revise the prospective payment system (PPS) for skilled nursing facilities. In 2019, the Secretary should report to the Congress on the effects of the reformed PPS and make any additional adjustments to… Read more »	Delivery system reforms Post-acute care	March 2016
The Medicare Advantage program: Status report (1) The Congress should eliminate the cap on benchmark amounts and the doubling of the quality increases in specified counties.	Part C (Medicare Advantage) Quality	March 2016
The Medicare Advantage program: Status report (2) The Congress should direct the Secretary to: develop a risk adjustment model that uses two years of fee-for-service (FFS) and Medicare Advantage (MA) diagnostic data and does not include diagnoses from health risk assessments from either FFS or MA, and then apply a coding adjustment that fully accounts for the remaining differences in coding between… Read more »	Part C (Medicare Advantage)	March 2016
Hospital short-stay policy issues (1) The Secretary should: direct recovery audit contractors (RACs) to focus reviews of short inpatient stays on hospitals with the highest rates of this type of stay, modify each RAC’s contingency fees to be based, in part, on its claim denial overturn rate, ensure that the RAC look-back period is shorter than the Medicare rebilling period… Read more »	Hospital	June 2015

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