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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

Issues in Medicare beneficiaries’ access to primary care (1)

The Congress should require advanced practice registered nurses and physician assistants to bill the Medicare program directly, eliminating “incident to” billing for services they provide.

  • Physicians and other health professionals

June 2019

Issues in Medicare beneficiaries’ access to primary care (2)

The Secretary should refine Medicare’s specialty designations for advanced practice registered nurses and physician assistants.

  • Physicians and other health professionals

June 2019

Physician and other health professional services

For calendar year 2020, the Congress should increase the calendar year 2019 payment rates for physician and other health professional services by the amount specified in current law.

  • Physicians and other health professionals

March 2019

Moving beyond the Merit-based Incentive Payment System

The Congress should: eliminate the current Merit-based Incentive Payment System; and establish a new voluntary value program in fee-for-service Medicare in which: clinicians can elect to be measured as part of a voluntary group; and clinicians in voluntary groups can qualify for a value payment based on their group’s performance on a set of population-based… Read more »

  • Delivery system reforms
  • Physicians and other health professionals

March 2018

Physician and other health professional services

For calendar year 2019, the Congress should increase the calendar year 2018 payment rates for physician and other health professional services by the amount specified in current law.

  • Physicians and other health professionals

March 2018

Physician and other health professional services

The Congress should increase payment rates for physician and other health professional services by the amount specified in current law for calendar year 2018.

  • Physicians and other health professionals

March 2017

Physician and other health professional services

The Congress should increase payment rates for physician and other health professional services by the amount specified in current law for calendar year 2017.

  • Physicians and other health professionals

March 2016

Physician and other health professional services

The Congress should establish a prospective per beneficiary payment to replace the Primary Care Incentive Payment program (PCIP) after it expires at the end of 2015. The per beneficiary payment should equal the average per beneficiary payment under the PCIP and should be exempt from beneficiary cost sharing. Funding for the per beneficiary payment should… Read more »

  • Delivery system reforms
  • Physicians and other health professionals

March 2015

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 (2)

To avoid caps without exceptions, the Congress should: reduce the therapy cap for physical therapy and speech-language pathology services combined and the separate cap for occupational therapy to $1,270 in 2013. These caps should be updated each year by the Medicare Economic Index. direct the Secretary to implement a manual review process for requests to… Read more »

  • Ambulatory care settings
  • Beneficiaries and coverage
  • Physicians and other health professionals

June 2013