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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
Enhancing Medicare’s technical assistance to and oversight of providers (6) The Secretary should establish a public recognition program for high-performing providers that participate in collaboratives or learning networks, or otherwise act as mentors, to improve the quality of lower performing providers.	Physicians and other health professionals Quality	June 2011
Improving payment accuracy and appropriate use of ancillary services (1) The Secretary should accelerate and expand efforts to package discrete services in the physician fee schedule into larger units for payment.	Physicians and other health professionals	June 2011
Improving payment accuracy and appropriate use of ancillary services (2) The Congress should direct the Secretary to apply a multiple procedure payment reduction to the professional component of diagnostic imaging services provided by the same practitioner in the same session.	Physicians and other health professionals	June 2011
Improving payment accuracy and appropriate use of ancillary services (3) The Congress should direct the Secretary to reduce the physician work component of imaging and other diagnostic tests that are ordered and performed by the same practitioner.	Physicians and other health professionals	June 2011
Improving payment accuracy and appropriate use of ancillary services (4) The Congress should direct the Secretary to establish a prior authorization program for practitioners who order substantially more advanced diagnostic imaging services than their peers.	Physicians and other health professionals	June 2011
Ambulatory surgical centers The Congress should implement a 0.5 percent increase in payment rates for ambulatory surgical center services in calendar year 2012 concurrent with requiring ambulatory surgical centers to submit cost and quality data.	Ambulatory care settings	March 2011
Home health services (1) The Secretary, with the Office of Inspector General, should conduct medical review activities in counties that have aberrant home health utilization. The Secretary should implement the new authorities to suspend payment and the enrollment of new providers if they indicate significant fraud.	Post-acute care	March 2011
Home health services (2) The Congress should direct the Secretary to begin a two-year rebasing of home health rates in 2013 and eliminate the market basket update for 2012.	Post-acute care	March 2011
Home health services (3) The Secretary should revise the home health case-mix system to rely on patient characteristics to set payment for therapy and non-therapy services and should no longer use the number of therapy visits as a payment factor.	Post-acute care	March 2011
Home health services (4) The Congress should direct the Secretary to establish a per episode copay for home health episodes that are not preceded by hospitalization or post-acute care use.	Beneficiaries and coverage Post-acute care	March 2011