An official website of the United States Government —

Here’s how you know

Official websites use .gov

A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS

A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

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) Publication

Update on the Medicare Advantage program (5)

The Congress should require special needs plans to enroll at least 95 percent of their members from their target population.

  • Part C (Medicare Advantage)

March 2008 - Chapter 3

Update on the Medicare Advantage program (6)

The Congress should eliminate dual-eligible and institutionalized beneficiaries’ ability to enroll in Medicare Advantage plans, except special needs plans with state contracts, outside of open enrollment. They should also continue to be able to disenroll and return to fee-for-service at any time during the year.

  • Part C (Medicare Advantage)

March 2008 - Chapter 3

Update on the Medicare Advantage program (7)

The Congress should extend the authority for special needs plans that meet the conditions specified in Recommendations 3-1 through 3-6 for three years.

  • Part C (Medicare Advantage)

March 2008 - Chapter 3

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 »

  • Part C (Medicare Advantage)
  • Regional issues

June 2005 - Chapter 2

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.

  • Part C (Medicare Advantage)
  • Regional issues

June 2005 - Chapter 2

The Medicare Advantage program (A)

The Congress should eliminate the stabilization fund for regional preferred provider organizations.

  • Part C (Medicare Advantage)

June 2005 - Chapter 3

The Medicare Advantage program (B)

The Secretary should calculate clinical measures for the fee-for-service program that would permit CMS to compare the fee-for-service program to Medicare Advantage plans.

  • Part C (Medicare Advantage)

June 2005 - Chapter 3

The Medicare Advantage program (C)

The Congress should clarify that regional plans should submit bids that are standardized for the region’s Medicare Advantage-eligible population.

  • Part C (Medicare Advantage)

June 2005 - Chapter 3

The Medicare Advantage program (D)

The Congress should remove the effect of payments for indirect medical education from the Medicare Advantage plan benchmarks.

  • Hospital
  • Part C (Medicare Advantage)

June 2005 - Chapter 3

The Medicare Advantage program (E)

a) The Congress should set the benchmarks that CMS uses to evaluate Medicare Advantage plan bids at 100 percent of the fee-for-service costs. b) At the same time, the Congress should also redirect Medicare’s share of savings from bids below the benchmarks to a fund that would redistribute the savings back to Medicare Advantage plans… Read more »

  • Part C (Medicare Advantage)

June 2005 - Chapter 3