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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

Access to home health services (A)

The Secretary should speed the development of regulations that outline home health care coverage and eligibility criteria based on clinical characteristics of beneficiaries. The Secretary should report to the Congress recommending the legislation needed to accomplish the implementation of these regulations.

  • Beneficiaries and coverage
  • Post-acute care

June 1999

Access to home health services (B)

The Secretary should use criteria based on clinical characteristics of beneficiaries to monitor use of home health services.

  • Post-acute care

June 1999

Access to home health services (C)

If the Congress is not confident that the Secretary can implement a prospective payment system for home health services by 2000, then it should explore the feasibility of establishing a process for agencies to exclude a small share of their patients from the aggregate per-beneficiary limits. Such a policy should be implemented in a budget-neutral… Read more »

  • Delivery system reforms
  • Post-acute care

June 1999

Access to home health services (D)

The Secretary should establish a national uniform process to ensure that fiscal intermediaries have the training and ability to provide timely and accurate coverage and payment information to home health agencies.

  • Post-acute care

June 1999

Access to home health services (E)

The Secretary should improve the applicability of the Medicare fee-for-service appeals process for home health users and establish a mechanism for informing beneficiaries about their rights to appeal determinations of noncoverage by home health agencies.

  • Post-acute care

June 1999

Post-Acute Care Providers: Moving toward Prospective Payment (A)

The Secretary should collect a core set of patient assessment information across all post-acute settings.

  • Post-acute care

March 1999

Post-Acute Care Providers: Moving toward Prospective Payment (B)

The Secretary should establish quality monitoring systems for post-acute care as prospective payment systems are implemented.

  • Post-acute care
  • Quality

March 1999

Post-Acute Care Providers: Moving toward Prospective Payment (C)

The Secretary should conduct a demonstration to assess the potential of the Functional Independence Measure-Function Related Groups classification system to predict the resource use of intensive rehabilitation patients in skilled nursing facilities.

  • Post-acute care
  • Quality

March 1999

Post-Acute Care Providers: Moving toward Prospective Payment (D)

The Secretary should continue to refine the classification system used in the skilled nursing facility prospective payment system to improve its ability to predict the resources associated with nontherapy ancillary services.

  • Post-acute care
  • Quality

March 1999

Post-Acute Care Providers: Moving toward Prospective Payment (E)

The Secretary should explore the potential for revising the rehabilitation groups of the classification system used in the skilled nursing facility prospective payment system to reduce reliance on measurements of rehabilitation time.

  • Delivery system reforms
  • Post-acute care

March 1999