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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
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
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.	Post-acute care	March 1999
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.	Hospital	March 1999
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.	Hospital	March 1999
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.	Hospital	March 1999
Updating and reforming prospective payment for hospital inpatient care (A) For the annual update to hospital inpatient payments under Medicare’s prospective payment system: The operating update of market basket minus 1.8 percentage points set in law for fiscal year 2000 will provide reasonable payment rates. An update of that level, which will be 0.7 percent if the current market basket estimate holds, is within the… Read more »	Hospital	March 1999
Updating and reforming prospective payment for hospital inpatient care (B) For the annual update to hospital inpatient payments under Medicare’s prospective payment system: The Secretary should increase the capital payment rates for fiscal year 2000 by between market basket minus 3.0 percentage points and market basket minus 0.1 percentage point. With the current estimate of the market basket, this corresponds to an update of -1.1… Read more »	Hospital	March 1999