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) | Publication |
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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 » |
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Medicare Part B drug and oncology payment policy issuesThe Secretary should reduce the Medicare Part B dispensing and supplying fee to rates similar to other payers. |
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Hospital inpatient and outpatient servicesThe Congress should direct the Secretary of the Department of Health and Human Services to: update inpatient and outpatient payments by the amount specified in current law; reduce Medicare payment rates for 340B hospitals’ separately payable Part B drugs by 10 percent of the average sales price; direct the program savings from reducing Part B… Read more » |
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Hospital short-stay policy issues (5)The Congress should package payment for self-administered drugs provided during outpatient observation on a budget-neutral basis within the hospital outpatient prospective payment system. |
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Status report on Part D, with focus on beneficiaries with high drug spendingThe Congress should modify the Part D low-income subsidy copayments for Medicare beneficiaries with incomes at or below 135 percent of poverty to encourage the use of generic drugs when available in selected therapeutic classes. The Congress should direct the Secretary to develop a copay structure, giving special consideration to eliminating the cost sharing for… Read more » |
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Public reporting of physicians’ financial relationships (1)The Congress should require all manufacturers and distributors of drugs, biologicals, medical devices, and medical supplies (and their subsidiaries) to report to the Secretary their financial relationships with: * Physicians, physician groups, and other prescribers; * Pharmacies and pharmacists; * Health plans, pharmacy benefit managers, and their employees; * Hospitals and medical schools; * Organizations… Read more » |
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Public reporting of physicians’ financial relationships (2)The Congress should direct the Secretary to post the information submitted by manufacturers on a public website in a format that is searchable by: * Manufacturer; * Recipient’s name, location, and specialty (if applicable); * Type of payment; * Name of the related drug or device (if applicable); and * Year. |
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Public reporting of physicians’ financial relationships (3)The Congress should require manufacturers and distributors of drugs to report to the Secretary the following information about drug samples: * Each recipient’s name and business address; * The name, dosage, and number of units of each sample; and * The date of distribution. The Secretary should make this information available through data use agreements. |
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Increasing participation in the Medicare Savings Programs and the low-income drug subsidy (1)The Secretary should increase the State Health Insurance Assistance Program funding for outreach to low-income Medicare beneficiaries. |
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Increasing participation in the Medicare Savings Programs and the low-income drug subsidy (2)The Congress should raise Medicare Savings Program income and asset criteria to conform to low-income drug subsidy criteria. |
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