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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

Changing Medicare’s Payment Systems for Ambulatory Care Facilities (J)

In changing the prospective payment system for ambulatory surgical centers, the Secretary should: Carefully monitor changes in service provision between the ambulatory surgical center and physician office setting that may occur after HCFA’s loosening of numerical guidelines for determining ambulatory surgical center list eligibility.

  • Ambulatory care settings

March 1999

Continuing Reform of Medicare Payments to Physicians (A)

To refine practice expense relative value units for the Medicare Fee Schedule, the Secretary of Health and Human Services should: Determine whether a clinical consensus exists about the appropriate settings in which services should be provided. For services that should not be provided in physicians’ offices, the Secretary should set both the office and facility… Read more »

  • Physicians and other health professionals

March 1999

Continuing Reform of Medicare Payments to Physicians (B)

To refine practice expense relative value units for the Medicare Fee Schedule, the Secretary of Health and Human Services should: Use a service-by-service approach to decide which services are subject to a site-of-service differential.

  • Physicians and other health professionals

March 1999

Continuing Reform of Medicare Payments to Physicians (C)

To refine practice expense relative value units for the Medicare Fee Schedule, the Secretary of Health and Human Services should: Include in the refinement process participants with expertise in payment methods, survey research, and accounting: representatives from the physician community; and payers other than Medicare.

  • Physicians and other health professionals

March 1999

Continuing Reform of Medicare Payments to Physicians (D)

To prepare for implementation of new professional liability insurance expense relative value units, the Secretary should: Consider the frequency of closed malpractice claims with payment, by service, as a basis for the relative value units. Such relative value units would reflect each service’s risk of a malpractice claim and would be resourced based.

  • Physicians and other health professionals

March 1999

Continuing Reform of Medicare Payments to Physicians (E)

To improve the sustainable growth rate system, the Congress should: Revise the sustainable growth rate to include measures of changes in the composition of Medicare fee-for-service enrollment.

  • Physicians and other health professionals

March 1999

Continuing Reform of Medicare Payments to Physicians (F)

To improve the sustainable growth rate system, the Congress should: Revise the sustainable growth rate to include a factor of growth in real gross domestic product per capita plus an allowance for cost increases due to improvements in medical capabilities and advancements in scientific technology.

  • Physicians and other health professionals

March 1999

Continuing Reform of Medicare Payments to Physicians (G)

To improve the sustainable growth rate system, the Congress should: Amend a provision of the Balanced Budget Act of 1997 to require the Secretary to publish an estimate of conversion factor updates by March 31 of the year before their implementation.

  • Physicians and other health professionals

March 1999

Continuing Reform of Medicare Payments to Physicians (H)

To improve the sustainable growth rate system, the Congress should: Reduce time lags between sustainable growth rate measurement periods by allowing calculation of the sustainable growth rate and update adjustment factors on a calendar year basis.

  • Physicians and other health professionals

March 1999

Continuing Reform of Medicare Payments to Physicians (I)

To improve the sustainable growth rate system, the Congress should: Require the Secretary to correct estimates used in sustainable growth rate system calculations every year.

  • Physicians and other health professionals

March 1999