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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) Publication

Medicare Advantage special needs plans (1)

The Congress should permanently reauthorize institutional special needs plans.

  • Part C (Medicare Advantage)

March 2013 - Chapter 14

Medicare Advantage special needs plans (2)

The Congress should: allow the authority for chronic care special needs plans (C–SNPs) to expire, with the exception of C–SNPs for a small number of conditions, including end-stage renal disease, HIV/AIDS, and chronic and disabling mental health conditions; direct the Secretary, within three years, to permit Medicare Advantage plans to enhance benefit designs so that… Read more »

  • Beneficiaries and coverage
  • Part C (Medicare Advantage)

March 2013 - Chapter 14

Medicare Advantage special needs plans (3)

The Congress should permanently reauthorize dual-eligible special needs plans (D–SNPs) that assume clinical and financial responsibility for Medicare and Medicaid benefits and allow the authority for all other D–SNPs to expire.

  • Part C (Medicare Advantage)

March 2013 - Chapter 14

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 »

  • Beneficiaries and coverage
  • Part C (Medicare Advantage)

March 2013 - Chapter 14

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 »

  • Part C (Medicare Advantage)

June 2012 - Chapter 3

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 »

  • Part C (Medicare Advantage)

June 2012 - Chapter 3

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.

  • Part C (Medicare Advantage)

June 2012 - Chapter 3

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 »

  • Part C (Medicare Advantage)

June 2012 - Chapter 3

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.

  • Part C (Medicare Advantage)
  • Quality

June 2012 - Chapter 3

Report on comparing quality among Medicare Advantage plans and between Medicare Advantage and fee-for-service Medicare (2)

The Secretary should collect, calculate, and report quality measurement results in Medicare Advantage at the level of the geographic units the Commission has recommended for Medicare Advantage payments, and calculate fee-for-service quality results for purposes of comparing Medicare Advantage and fee-for-service using the same geographic units.

  • Part C (Medicare Advantage)
  • Quality

March 2010 - Chapter 6