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 |
|---|---|---|
Medicare Advantage special needs plans (4)For dual-eligible special needs plans (D–SNPs) that assume clinical and financial responsibility for Medicare and Medicaid benefits, the Congress should: grant the Secretary authority to align the Medicare and Medicaid appeals and grievances processes; direct the Secretary to allow these D–SNPs to market the Medicare and Medicaid benefits they cover as a combined benefit package;… Read more » |
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March 2013 |
Outpatient dialysis servicesThe Congress should not increase the outpatient dialysis bundled payment rate for calendar year 2014. |
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March 2013 |
Care coordination programs for dual-eligible beneficiaries (1)The Congress should direct the Secretary to improve the Medicare Advantage (MA) risk-adjustment system to more accurately predict risk across all MA enrollees. Using the revised risk-adjustment system, the Congress should direct the Secretary to pay Program of All-Inclusive Care for the Elderly providers based on the MA payment system for setting benchmarks and quality… Read more » |
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June 2012 |
Care coordination programs for dual-eligible beneficiaries (2)After the changes in the recommendation to improve the Medicare Advantage (MA) risk-adjustment system and pay Program of All-Inclusive Care for the Elderly providers based on the MA payment system take effect (see above), the Congress should change the age eligibility criteria for the Program of All-Inclusive Care for the Elderly to allow nursing home-certifiable… Read more » |
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June 2012 |
Care coordination programs for dual-eligible beneficiaries (3)After the changes in the recommendation to improve the Medicare Advantage (MA) risk-adjustment system and pay Program of All-Inclusive Care for the Elderly providers based on the MA payment system take effect, the Secretary should provide prorated capitation payments to Program of All-Inclusive Care for the Elderly providers for partial-month enrollees. |
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June 2012 |
Care coordination programs for dual-eligible beneficiaries (4)After the changes in the recommendation to improve the Medicare Advantage (MA) risk-adjustment system and pay Program of All-Inclusive Care for the Elderly providers based on the MA payment system take effect, the Secretary should establish an outlier protection policy for new Program of All-Inclusive Care for the Elderly sites to use during the first… Read more » |
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June 2012 |
Care coordination programs for dual-eligible beneficiaries (5)The Congress should direct the Secretary to publish select quality measures on Program of All-Inclusive Care for the Elderly (PACE) providers and develop appropriate quality measures to enable PACE providers to participate in the Medicare Advantage quality bonus program by 2015. |
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June 2012 |
Reforming Medicare’s benefit designThe Congress should direct the Secretary to develop and implement a fee-for-service benefit design that would replace the current design and would include: an out-of-pocket maximum; deductible(s) for Part A and Part B services; replacing coinsurance with copayments that may vary by type of service and provider; secretarial authority to alter or eliminate cost sharing… Read more » |
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June 2012 |
Ambulatory surgical center services (1)The Congress should update the payment rates for ambulatory surgical centers by 0.5 percent for calendar year 2013. The Congress should also require ambulatory surgical centers to submit cost data. |
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March 2012 |
Ambulatory surgical center services (2)The Congress should direct the Secretary to implement a value-based purchasing program for ambulatory surgical center services no later than 2016. |
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March 2012 |