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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

Outpatient dialysis services

The Congress should update the composite rate by the projected rate of increase in the end-stage renal disease market basket index less 0.4 percent for calendar year 2006.

  • Ambulatory care settings

March 2005

Strategies to improve care: Pay for performance and information technology (F)

CMS should require those who perform laboratory tests to submit laboratory values, using common vocabulary standards.

  • Ambulatory care settings

March 2005

Ambulatory surgical center services (1)

There should be no update to payment rates for ASC services for fiscal year 2005.

  • Ambulatory care settings

February 2004

Ambulatory surgical center services (2)

The Secretary should revise the ASC payment system so that its relative weights and procedure groups are aligned with those in the outpatient prospective payment system. In addition: * The Congress should require the Secretary to periodically collect ASC cost data at the procedure level to monitor the adequacy of ASC rates, refine the relative… Read more »

  • Ambulatory care settings

February 2004

Ambulatory surgical center services (3)

After the ASC payment system is revised, the Congress should direct the Secretary to replace the current list of approved ASC procedures with a list of procedures that are excluded from payment based on clinical safety standards and whether the service requires an overnight stay.

  • Ambulatory care settings
  • Quality

February 2004

Medicare+Choice payment and eligibility policy (B)

The Congress should allow all beneficiaries with end-stage renal disease to enroll in private plans.

  • Ambulatory care settings
  • Beneficiaries and coverage
  • Part C (Medicare Advantage)

February 2004

Medicare+Choice payment and eligibility policy (A)

CMS should continue to risk-adjust payments with the new CMS hierarchical condition category system, but should not continue to offset the impact of risk adjustment on overall payments in 2005 and subsequent years.

  • Ambulatory care settings

February 2004

Outpatient dialysis services (1)

The Congress should maintain current law and update the composite rate by 1.6 percent for 2005.

  • Ambulatory care settings

February 2004

Outpatient dialysis services (2)

The Congress should establish a quality incentive payment policy for physicians and facilities providing outpatient dialysis services.

  • Ambulatory care settings
  • Delivery system reforms
  • Physicians and other health professionals

February 2004

Ambulatory surgical center services (1)

The Secretary should expedite collection of recent ASC charge and cost data for the purpose of analyzing and revising the ASC payment system

  • Ambulatory care settings

February 2003