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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

The Congress should direct the Secretary of Health and Human Services to: reduce or eliminate differences in payment rates between outpatient departments and physician offices for selected ambulatory payment classifications. set long-term care hospital base payment rates for non-chronically critically ill cases equal to those of acute care hospitals and redistribute the savings to create… Read more »

  • Ambulatory care settings
  • Hospital
  • Post-acute care

March 2014

Inpatient rehabilitation facility services

The Congress should eliminate the update to the Medicare payment rates for inpatient rehabilitation facilities in fiscal year 2015.

  • Post-acute care

March 2014

Long-term care hospital services

The Secretary should eliminate the update to the payment rates for long-term care hospitals for fiscal year 2015.

  • Post-acute care

March 2014

Outpatient dialysis services (1)

The Congress should not increase the outpatient dialysis payment rate for calendar year 2015.

  • Ambulatory care settings

March 2014

Outpatient dialysis services (2)

The Congress should direct the Secretary to: * include a measure that assesses poor outcomes related to anemia in the End-Stage Renal Disease Quality Incentive Program. * redesign the low-volume payment adjustment to consider a facility’s distance to the nearest facility. * audit dialysis facilities’ cost report data.

  • Ambulatory care settings
  • Quality

March 2014

Post-acute care providers: Steps toward broad payment reforms

The Congress should direct the Secretary to implement common patient assessment items for use in home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals by 2016.

  • Post-acute care

March 2014

The Medicare Advantage program: Status report (1)

The Congress should direct the Secretary to determine payments for employer group Medicare Advantage plans in a manner more consistent with the determination of payments for comparable non-employer plans.

  • Part C (Medicare Advantage)

March 2014

The Medicare Advantage program: Status report (2)

The Congress should include the Medicare hospice benefit in the Medicare Advantage benefits package beginning in 2016.

  • Part C (Medicare Advantage)

March 2014

Mandated report: Geographic adjustment of payments for the work of physicians and other health professionals

Medicare payments for work under the fee schedule for physicians and other health professionals should be geographically adjusted. The adjustment should reflect geographic differences across labor markets for physicians and other health professionals. The Congress should allow the geographic practice cost index (GPCI) floor to expire per current law and, because of uncertainty in the… Read more »

  • Physicians and other health professionals
  • Regional issues

June 2013

Mandated report: Improving Medicare’s payment system for outpatient therapy services (1)

The Congress should direct the Secretary to: reduce the certification period for the outpatient therapy plan of care from 90 days to 45 days, and develop national guidelines for therapy services, implement payment edits at the national level based on these guidelines that target implausible amounts of therapy, and use authorities granted by the Patient… Read more »

  • Ambulatory care settings

June 2013