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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

End-stage renal disease payment policies in traditional Medicare (D)

The Congress should instruct the Secretary to develop a wage index based on market wage rates for occupations typically used in furnishing dialysis.

  • Ambulatory care settings

March 2001

End-stage renal disease payment policies in traditional Medicare (E)

For calendar year 2002, the composite rate for outpatient dialysis services should remain unchanged.

  • Ambulatory care settings

March 2001

Updating payments for physician services and for care provided in hospital outpatient departments (C)

The Secretary should not use an expenditure target to update the conversion factor in the outpatient prospective payment system or to update payments for other ambulatory care settings.

  • Ambulatory care settings
  • Hospital

March 2001

Assessing the design and impact of the hospital outpatient prospective payment system (A)

The Secretary should monitor changes in practice patterns across ambulatory care settings to ensure that differences in payment do not lead to inappropriate shifts in site of care.

  • Ambulatory care settings
  • Delivery system reforms
  • Hospital

June 2000

Improving payment for end-stage renal disease services (A)

As soon as possible, the Secretary should risk-adjust payments for patients with end-stage renal disease (ESRD) enrolled in Medicare+Choice.

  • Ambulatory care settings
  • Delivery system reforms

March 2000

Improving payment for end-stage renal disease services (B)

The Congress should require HCFA to annually review the composite rate payment.

  • Ambulatory care settings

March 2000

Improving payment for end-stage renal disease services (C)

For fiscal year 2001, the composite rate for outpatient dialysis services should be increased by 2.4 percent.

  • Ambulatory care settings

March 2000

Improving payment for end-stage renal disease services (D)

HCFA should collect information on ESRD patients’ satisfaction with the quality of and access to care.

  • Ambulatory care settings

March 2000

Improving payment for end-stage renal disease services (E)

Once HCFA has implemented a risk-adjusted payment system and a system to monitor and report on the quality of care, the Congress should lift the bar prohibiting patients with ESRD from enrolling in Medicare+Choice.

  • Ambulatory care settings
  • Part C (Medicare Advantage)

March 2000

Improving payment for end-stage renal disease services (F)

ESRD patients who lose Medicare+Choice coverage because their plan leaves the area should be permitted to enroll in another Medicare+Choice plan.

  • Ambulatory care settings
  • Part C (Medicare Advantage)

March 2000