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.
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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. |
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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. |
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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. |
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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. |
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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. |
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Payment for new technologies in Medicare’s prospective payment systemsThe Secretary should introduce clinical criteria for eligibility of drugs and biologicals to receive pass-through payments under the outpatient prospective payment system. |
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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. |
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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. |
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Paying for new technology in the outpatient prospective payment system (A)The Congress should: * Replace hospital-specific payments for pass-through devices with national rates. * Give the Secretary authority to consider alternatives to average wholesale price when determining payments for pass-through drugs and biologicals. |
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Assessing payment for outpatient hospital care in rural areasIn the short term, no outpatient payment adjustments for rural hospitals are needed in addition to the current hold-harmless provision. The Secretary should revisit outpatient payments to rural hospitals when better information on hospitals’ experience with the payment system is available. |
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