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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

Long-term care hospital services

For fiscal year 2021, the Secretary should increase the fiscal year 2020 Medicare base payment rates for long-term care hospitals by 2 percent.

  • Post-acute care

March 2020

Outpatient dialysis services

For CY 2021, the Congress should update the CY 2020 Medicare ESRD PPS base rate by the amount determined in current law

  • Ambulatory care settings

March 2020

Physician and other health professional services

For calendar year 2021, the Congress should increase the calendar year 2020 payment rates for physician and other health professional services by the amount specified in current law.

  • Physicians and other health professionals

March 2020

Skilled nursing facility services

For fiscal year 2021, the Congress should eliminate the update to the fiscal year 2020 Medicare base payment rates for skilled nursing facilities.

  • Post-acute care

March 2020

Ensuring the accuracy and completeness of Medicare Advantage encounter data

The Congress should direct the Secretary to establish thresholds for the completeness and accuracy of Medicare Advantage (MA) encounter data and: rigorously evaluate MA organizations’ submitted data and provide robust feedback; concurrently apply a payment withhold and provide refunds to MA organizations that meet thresholds; and institute a mechanism for direct submission of provider claims… Read more »

  • Part C (Medicare Advantage)

June 2019

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

Options for slowing the growth of Medicare fee-for-service spending for emergency department services

The Secretary should develop and implement a set of national guidelines for coding hospital emergency department visits under the outpatient prospective payment system by 2022.

  • Hospital

June 2019

Ambulatory surgical center services

The Congress should eliminate the calendar year 2020 update to the Medicare conversion factor for ambulatory surgical centers. The Secretary should require ambulatory surgical centers to report cost data.

  • Ambulatory care settings

March 2019

Home health care services

For 2020, the Congress should reduce the calendar year 2019 Medicare base payment rate for home health agencies by 5 percent.

  • Post-acute care

March 2019