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) | Publication |
|---|---|---|
Outpatient dialysis servicesFor CY 2021, the Congress should update the CY 2020 Medicare ESRD PPS base rate by the amount determined in current law |
|
|
Physician and other health professional servicesFor calendar year 2021, the Congress should increase the calendar year 2020 payment rates for physician and other health professional services by the amount specified in current law. |
|
|
Skilled nursing facility servicesFor fiscal year 2021, the Congress should eliminate the update to the fiscal year 2020 Medicare base payment rates for skilled nursing facilities. |
|
|
Ensuring the accuracy and completeness of Medicare Advantage encounter dataThe Congress should direct the Secretary to establish thresholds for the completeness and accuracy of Medicare Advantage (MA) encounter data and: rigorously evaluate MA organizations’ submitted data and provide robust feedback; concurrently apply a payment withhold and provide refunds to MA organizations that meet thresholds; and institute a mechanism for direct submission of provider claims… Read more » |
|
|
Issues in Medicare beneficiaries’ access to primary care (1)The Congress should require advanced practice registered nurses and physician assistants to bill the Medicare program directly, eliminating “incident to” billing for services they provide. |
|
|
Issues in Medicare beneficiaries’ access to primary care (2)The Secretary should refine Medicare’s specialty designations for advanced practice registered nurses and physician assistants. |
|
|
Options for slowing the growth of Medicare fee-for-service spending for emergency department servicesThe Secretary should develop and implement a set of national guidelines for coding hospital emergency department visits under the outpatient prospective payment system by 2022. |
|
|
Ambulatory surgical center servicesThe Congress should eliminate the calendar year 2020 update to the Medicare conversion factor for ambulatory surgical centers. The Secretary should require ambulatory surgical centers to report cost data. |
|
|
Home health care servicesFor 2020, the Congress should reduce the calendar year 2019 Medicare base payment rate for home health agencies by 5 percent. |
|
|
Hospice servicesFor 2020, the Congress should reduce the fiscal year 2019 Medicare base payment rates for hospice providers by 2 percent. |
|