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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

Post-Acute Care Providers: Moving toward Prospective Payment (E)

The Secretary should explore the potential for revising the rehabilitation groups of the classification system used in the skilled nursing facility prospective payment system to reduce reliance on measurements of rehabilitation time.

  • Delivery system reforms
  • Post-acute care

March 1999

Post-Acute Care Providers: Moving toward Prospective Payment (F)

The Secretary should develop a method for updating payment weights in the skilled nursing facility prospective payment system as soon as possible.

  • Post-acute care

March 1999

Post-Acute Care Providers: Moving toward Prospective Payment (G)

The Secretary should identify any distortions in the base payment rates of the skilled nursing facility prospective payment system and explore options for correcting them as better data become available.

  • Post-acute care

March 1999

Post-Acute Care Providers: Moving toward Prospective Payment (H)

The Secretary should develop ways to ensure skilled nursing facilities’ accountability for accurately assessing patient needs and classifying them for payment purposes.

  • Post-acute care

March 1999

Post-Acute Care Providers: Moving toward Prospective Payment (I)

The Secretary should develop a wage index based on skilled nursing facility wage data and use it to adjust payments for those facilities’ services.

  • Post-acute care

March 1999

Post-Acute Care Providers: Moving toward Prospective Payment (J)

The Secretary should develop a discharge-based prospective payment system for rehabilitation facility patients based on the Functional Independence Measure-Function Related Groups classification system. Policies to address transfers and short-stay outliers would be necessary components of such a system.

  • Delivery system reforms
  • Post-acute care

March 1999

Post-Acute Care Providers: Moving toward Prospective Payment (K)

The Congress should establish in law clear eligibility and coverage guidelines for home health services.

  • Beneficiaries and coverage
  • Post-acute care

March 1999

Post-Acute Care Providers: Moving toward Prospective Payment (L)

The Secretary should require home health agencies to use consistent, service-specific codes on all patient bills for services provided during home health visits.

  • Post-acute care

March 1999

Post-Acute Care Providers: Moving toward Prospective Payment (M)

The Congress should require independent assessments of need for beneficiaries receiving extensive home health services to ensure the appropriateness of such care. Beneficiaries receiving 60 or more home health visits should qualify for assessments. Assessors should confer with prescribing physicians to modify care plans as needed.

  • Post-acute care

March 1999

Post-Acute Care Providers: Moving toward Prospective Payment (N)

The Congress should require modest beneficiary cost-sharing for home health services, subject to an annual limit. Low-income beneficiaries should be exempt from cost-sharing.

  • Beneficiaries and coverage
  • Post-acute care

March 1999