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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

Hospital inpatient and outpatient services (2)

The Congress should reduce the indirect medical education adjustment in 2009 by 1 percentage point to 4.5 percent per 10 percent increment in the resident-to-bed ratio. The funds obtained by reducing the indirect medical education adjustment should be used to fund a quality incentive payment program.

  • Hospital
  • Quality

February 2008

An alternative method to compute the wage index (A)

The Congress should repeal the existing hospital wage index statute, including reclassifications and exceptions, and give the Secretary authority to establish new wage index systems.

  • Hospital

June 2007

An alternative method to compute the wage index (B)

The Secretary should establish a hospital compensation index that: * Uses wage data from all employers and industry-specific occupational weights, * Is adjusted for geographic differences in the ratio of benefits to wages, * Is adjusted at the county level and smooths large differences between counties, and * Is implemented so that large changes in… Read more »

  • Hospital

June 2007

An alternative method to compute the wage index (C)

The Secretary should use the hospital compensation index described in recommendation 6B for the home health and skilled nursing facility prospective payment systems and evaluate its use in the other Medicare fee-for-service prospective payment systems.

  • Hospital

June 2007

Hospital inpatient and outpatient services (1)

The Congress should increase payment rates for the acute inpatient and outpatient prospective payment systems in 2008 by the projected rate of increase in the hospital market basket index, concurrent with implementation of a quality incentive payment program.

  • Hospital
  • Quality

March 2007

Hospital inpatient and outpatient services (2)

Concurrent with implementation of severity adjustment to Medicare’s diagnosis related group payments, the Congress should reduce the indirect medical education adjustment in fiscal year 2008 by 1 percentage point to 4.5 percent per 10 percent increment in the resident-to-bed ratio. The funds obtained from reducing the indirect medical education adjustment should be used to fund… Read more »

  • Hospital
  • Quality

March 2007

Hospital inpatient and outpatient services (3)

The Secretary should improve the form and accompanying instructions for collecting data on uncompensated care in the Medicare cost report and require hospitals to report using the revised form as soon as possible.

  • Hospital

March 2007

Hospital inpatient and outpatient services

The Congress should increase payment rates for the acute inpatient and outpatient prospective payment systems in 2007 by the projected increase in the hospital market basket index less half of the Commission’s expectation for productivity growth.

  • Hospital

March 2006

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.

  • Drugs, Devices, and Tests
  • Hospital

June 2005

Payment for pharmacy handling costs in hospital outpatient departments (B)

The Secretary should: * Define a set of handling fee APCs that group drugs, biologicals, and radiopharmaceuticals based on attributes of the products that affect handling costs; * Instruct hospitals to submit charges for those APCs; and * Base payment rates for the handling fee APCs on submitted charges, reduced to costs.

  • Drugs, Devices, and Tests
  • Hospital

June 2005