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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
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
Ambulatory surgical center services (2) The Congress should eliminate the update to payment rates for ASC services for fiscal year 2004.	Ambulatory care settings	February 2003
Ambulatory surgical center services (3) Until the Secretary implements a revised ASC payment system, the Congress should ensure that payment rates for ASC procedures do not exceed hospital outpatient PPS rates for those procedures, after accounting for differences in the bundle of services covered.	Ambulatory care settings	February 2003
Outpatient dialysis services The Congress should update the composite rate payment by the projected change in input prices, less 0.9 percent, for calendar year 2004.	Ambulatory care settings	February 2003
Hospital inpatient and outpatient services (3) For calendar year 2003, the Secretary should increase the payment rates for services covered by the outpatient prospective payment system by the rate of increase in the hospital market basket	Ambulatory care settings	March 2002
Outpatient dialysis services For calendar year 2003, the Congress should update the composite rate payment for outpatient dialysis services by 2.4 percent.	Ambulatory care settings	March 2002
End-stage renal disease payment policies in traditional Medicare (A) The Congress should instruct the Secretary to broaden the composite rate payment bundle to include widely used services currently excluded from it. The Secretary should continue to emphasize quality monitoring and quality improvement efforts to ensure that patients have access to high-quality dialysis care.	Ambulatory care settings	March 2001
End-stage renal disease payment policies in traditional Medicare (B) The Congress should instruct the Secretary to evaluate whether the composite rate’s unit of payment- a single dialysis session- should be revised to reflect better the way dialysis is furnished.	Ambulatory care settings	March 2001
End-stage renal disease payment policies in traditional Medicare (C) The Congress should instruct the Secretary to revise the outpatient dialysis payment system to account for factors that affect providers’ costs to deliver high-quality clinical care, including dialysis method, dose, frequency, and patient activity.	Ambulatory care settings	March 2001