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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

Hospital inpatient and outpatient services (1)

The Secretary should add 13 DRGs to the post-acute transfer policy in fiscal year 2004 and then evaluate the effects on hospitals and beneficiaries before proposing further expansions.
  • Hospital
  • Post-acute care

February 2003

Hospital inpatient and outpatient services (2)

The Congress should enact a low-volume adjustment to the rates used in the inpatient PPS. This adjustment should apply only to hospitals that are more than 15 miles from another facility offering acute inpatient care.
  • Hospital

February 2003

Hospital inpatient and outpatient services (3)

The Secretary should reevaluate the labor share used in the wage index system that geographically adjusts rates in the inpatient PPS, with any resulting changed phased in over two years.
  • Hospital

February 2003

Hospital inpatient and outpatient services (4)

The Congress should raise the inpatient base rate for hospitals in rural and other urban areas to the level of the rate for those in large urban areas, phased in over two years.
  • Hospital
  • Regional issues

February 2003

Hospital inpatient and outpatient services (5)

The Congress should raise the cap on the disproportionate share add-on a hospital can receive in the inpatient PPS from 5.25 percent to 10 percent, phased in over two years.
  • Hospital

February 2003

Hospital inpatient and outpatient services (6)

The Congress should increase payment rates for the inpatient PPS by the rate of increase in the hospital market basket, less 0.4 percent, for fiscal year 2004.
  • Hospital

February 2003

Hospital inpatient and outpatient services (7)

The Congress should increase payment rates for the outpatient PPS by the rate of increase in the hospital market basket, less 0.9 percent, for calendar year 2004.
  • Hospital

February 2003

Payment for new technologies in Medicare’s prospective payment systems

The Secretary should introduce clinical criteria for eligibility of drugs and biologicals to receive pass-through payments under the outpatient prospective payment system.
  • Drugs, Devices, and Tests
  • Hospital

February 2003

Hospital inpatient and outpatient services (1)

The Congress should gradually eliminate the differential in inpatient payment rates between hospitals in large urban and other areas.
  • Hospital

March 2002

Hospital inpatient and outpatient services (2)

The Congress should increase the base rate for inpatient services covered by Medicare’s prospective payment system in fiscal year 2003 by market basket minus 0.55 percent for hospitals in large urban areas and by market basket for hospitals in all other areas.
  • Hospital

March 2002