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.
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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. |
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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. |
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Post-Acute Care Providers: Moving toward Prospective Payment (K)The Congress should establish in law clear eligibility and coverage guidelines for home health services. |
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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. |
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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. |
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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. |
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Post-Acute Care Providers: Moving toward Prospective Payment (O)The Secretary should evaluate all relevant case-mix and prospective payment methodologies for their utility in developing a prospective payment system for long-term hospitals. |
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Providers Exempt from the Acute Care Prospective Payment System (A)To update and improve payments to providers exempt from the acute care prospective payment system, the Secretary should increase the market basket amount in the target amount update formula by 0.4 percentage points for fiscal year 2000. |
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Providers Exempt from the Acute Care Prospective Payment System (B)The Congress should adjust the wage-related portion of the target amount caps on exempt providers to account for geographic differences in labor costs. |
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Providers Exempt from the Acute Care Prospective Payment System (C)To update and improve payments to providers exempt from the acute care prospective payment system, the Secretary should encourage additional research in case-mix classification for psychiatric patients, with an eye toward developing a prospective payment system for them in the future. |
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