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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
Revising payment methods and monitoring quality of care in traditional Medicare (N) HCFA should continue to work with the medical community in developing guidelines for evaluation and management services, minimizing their complexity, and exploring alternative approaches to promote accurate coding of these services.	Physicians and other health professionals	March 2000
Revising payment methods and monitoring quality of care in traditional Medicare (O) HCFA should pilot-test documentation guidelines for evaluation and management services before their implementation, and/or pilot test any alternative method. The agency should continue to work with the medical community in developing the pilot tests, and should ensure adequate time for physician education.	Physicians and other health professionals	March 2000
Revising payment methods and monitoring quality of care in traditional Medicare (P) HCFA should disclose coding edits to physicians and should seek review of the appropriateness of those edits by the medical community.	Physicians and other health professionals	March 2000
Updating payment rates in traditional Medicare The Congress should not establish a single overall expenditure target that determines payment updates for physicians’ services and ambulatory care facilities. Within existing statutory authority, the Secretary should not establish setting-specific expenditure targets.	Ambulatory care settings Physicians and other health professionals	March 2000
Access to home health services (A) The Secretary should speed the development of regulations that outline home health care coverage and eligibility criteria based on clinical characteristics of beneficiaries. The Secretary should report to the Congress recommending the legislation needed to accomplish the implementation of these regulations.	Beneficiaries and coverage Post-acute care	June 1999
Access to home health services (B) The Secretary should use criteria based on clinical characteristics of beneficiaries to monitor use of home health services.	Post-acute care	June 1999
Access to home health services (C) If the Congress is not confident that the Secretary can implement a prospective payment system for home health services by 2000, then it should explore the feasibility of establishing a process for agencies to exclude a small share of their patients from the aggregate per-beneficiary limits. Such a policy should be implemented in a budget-neutral… Read more »	Delivery system reforms Post-acute care	June 1999
Access to home health services (D) The Secretary should establish a national uniform process to ensure that fiscal intermediaries have the training and ability to provide timely and accurate coverage and payment information to home health agencies.	Post-acute care	June 1999
Access to home health services (E) The Secretary should improve the applicability of the Medicare fee-for-service appeals process for home health users and establish a mechanism for informing beneficiaries about their rights to appeal determinations of noncoverage by home health agencies.	Post-acute care	June 1999
Addressing health care errors under Medicare (A) The Secretary should establish patient safety as a quality improvement priority for Medicare and should take steps to minimize the incidence of preventable errors in the delivery of care provided to beneficiaries.	Quality	June 1999