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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
Inpatient rehabilitation facility services (2) The Secretary should conduct focused medical record review of inpatient rehabilitation facilities that have unusual patterns of case mix and coding.	Post-acute care	March 2016
Inpatient rehabilitation facility services (3) The Secretary should expand the inpatient rehabilitation facility outlier pool to redistribute payments more equitably across cases and providers.	Post-acute care	March 2016
Long-term care hospital services The Secretary should eliminate the update to the payment rates for long-term care hospitals for fiscal year 2017.	Post-acute care	March 2016
Skilled nursing facility services The Congress should eliminate the market basket update for skilled nursing facilities for fiscal years 2017 and 2018 and direct the Secretary to revise the prospective payment system (PPS) for skilled nursing facilities. In 2019, the Secretary should report to the Congress on the effects of the reformed PPS and make any additional adjustments to… Read more »	Delivery system reforms Post-acute care	March 2016
Hospital short-stay policy issues (3) The Congress should revise the skilled nursing facility three-inpatient-day hospital eligibility requirement to allow for up to two outpatient observation days to count toward meeting the criterion.	Hospital Post-acute care	June 2015
Hospital short-stay policy issues (4) The Congress should require acute-care hospitals to notify beneficiaries placed in outpatient observation status that their observation status may affect their financial liability for skilled nursing facility care. The notice should be provided to patients in observation status for more than 24 hours and who are expected to need skilled nursing services. The notice should… Read more »	Hospital Post-acute care	June 2015
Hospice services The Congress should eliminate the update to the hospice payment rates for fiscal year 2016.	Post-acute care	March 2015
Inpatient rehabilitation facility services The Congress should eliminate the update to the Medicare payment rates for inpatient rehabilitation facilities in fiscal year 2016.	Post-acute care	March 2015
Long-term care hospital services The Secretary should eliminate the update to the payment rates for long-term care hospitals for fiscal year 2016.	Post-acute care	March 2015
Medicare’s post-acute care: Trends and ways to rationalize payments The Congress should direct the Secretary of Health and Human Services to eliminate the differences in payment rates between inpatient rehabilitation facilities (IRFs) and skilled nursing facilities for selected conditions. The reductions to IRF payments should be phased in over three years. IRFs should receive relief from regulations specifying the intensity and mix of services… Read more »	Delivery system reforms Post-acute care	March 2015