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 |
|---|---|---|
Improving Medicare’s policies for separately payable drugs in the hospital outpatient prospective payment system (2)The Secretary should specify that the separately payable non-pass-through policy in the hospital outpatient prospective payment system applies only to drugs and biologics that are the reason for a visit and meet a defined cost threshold. |
|
June 2021 |
Mandated report: Evaluating the skilled nursing facility value-based purchasing program (1)The Congress should eliminate Medicare’s current skilled nursing facility (SNF) value-based purchasing program and establish a new SNF value incentive program (VIP) that: scores a small set of performance measures; incorporates strategies to ensure reliable measure results; establishes a system for distributing rewards that minimizes cliff effects; accounts for differences in patient social risk factors… Read more » |
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June 2021 |
Mandated report: Evaluating the skilled nursing facility value-based purchasing program (2)The Secretary should finalize development of and begin to report patient experience measures for skilled nursing facilities. |
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June 2021 |
Medicare vaccine coverage and paymentThe Congress should: cover all appropriate preventative vaccines and their administration under Part B instead of Part D without beneficiary cost sharing and modify Medicare’s payment rate for Part B-covered preventative vaccines to be 103 percent of wholesale acquisition cost, and require vaccine manufacturers to report average sales price data to CMS for analysis. |
|
June 2021 |
Rebalancing Medicare Advantage benchmark policyThe Congress should replace the current Medicare Advantage (MA) benchmark policy with a new MA benchmark policy that applies: |
|
June 2021 |
Revising Medicare’s indirect medical education payments to better reflect teaching hospitals’ costsThe Congress should require CMS to transition to empirically justified indirect medical education adjustments to both inpatient and outpatient Medicare payments. |
|
June 2021 |
Streamlining CMS’s portfolio of alternative payment modelsThe Secretary should implement a more harmonized portfolio of fewer alternative payment models that are designed to work together to support the strategic objectives of reducing spending and improving quality |
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June 2021 |
Ambulatory surgical center services (1)For calendar year 2022, the Congress should eliminate the update to the 2021 Medicare conversion factor for ambulatory surgical centers. |
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March 2021 |
Ambulatory surgical center services (2)The Secretary should require ambulatory surgical centers to report cost data. |
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March 2021 |
Home health care servicesFor calendar year 2022, the Congress should reduce the 2021 Medicare base payment rate for home health agencies by 5 percent. |
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March 2021 |