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 |
|---|---|---|
Skilled nursing facility services (1)The Congress should eliminate the update to payment rates for skilled nursing facility services for fiscal year 2007. |
|
March 2006 |
Skilled nursing facility services (2)The Secretary should modify the PPS for skilled nursing facilities to more accurately capture the cost of providing care to different types of patients. This new system should: * Reflect clinically relevant categories of patients; * More accurately distribute payments for nontherapy ancillary services; * Improve incentives to provide rehabilitation services based on the need… Read more » |
|
March 2006 |
Skilled nursing facility services (3)To improve quality measurement, the Secretary should: * Collect information on activities of daily living at admission and at discharge; * Develop and use more quality indicators, including process measures, specific to short-stay patients in skilled nursing facilities; and * Put a high priority on developing appropriate quality measures for pay for performance. |
|
March 2006 |
Medicare Advantage payment areas and risk adjustment (A)The Congress should establish payment areas for Medicare Advantage local plans that have the following characteristics: * Among counties in metropolitan statistical areas, payment areas should be collections of counties that are located in the same state and the same metropolitan statistical area. * Among counties outside metropolitan statistical areas, payment areas should be collections… Read more » |
|
June 2005 |
Medicare Advantage payment areas and risk adjustment (B)The Secretary should update health service areas before using them as payment areas in the Medicare Advantage program. In addition, the Secretary should make periodic updates to health service areas to reflect changes in health care market areas that occur over time. |
|
June 2005 |
Monitoring the implementation of Part DThe Secretary should have a process in place for timely delivery of Part D data to congressional support agencies to enable them to report to the Congress on the drug benefit’s impact on cost, quality, and access. |
|
June 2005 |
Payment for dialysis (A)The Congress should direct the Secretary to: * Eliminate differences in paying for composite rate services between hospital-based and freestanding dialysis facilities; and * Combine the base composite rate and the add-on adjustment. |
|
June 2005 |
Payment for dialysis (B)The Secretary should: * Eliminate differences in paying for injectable drugs between hospital-based and freestanding dialysis facilities; and * Use average sales price data to base payment for all injectable dialysis drugs that are separately billable in 2006. |
|
June 2005 |
Payment for dialysis (C)The Congress should give the Secretary the authority to periodically collect average acquisition cost data from dialysis providers and compare it with average sales price data. The Secretary should collect data on the acquisition cost and payment per unit for drugs- other than erythropoietin- that hospital-based providers furnish. |
|
June 2005 |
Payment for pharmacy handling costs in hospital outpatient departments (A)The Secretary should establish separate, budget-neutral payments to cover the costs that hospitals incur for handling separately paid drugs, biologicals, and radiopharmaceuticals. |
|
June 2005 |