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 |
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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. |
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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. |
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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. |
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Improving payment for end-stage renal disease services (B)The Congress should require HCFA to annually review the composite rate payment. |
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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. |
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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. |
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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. |
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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. |
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Updating payment rates in traditional MedicareThe Congress should not establish a single overall expenditure target that determines payment updates for physicians’ services and ambulatory care facilities. Within existing statutory authority, the Secretary should not establish setting-specific expenditure targets. |
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Improving the quality of care for beneficiaries with end-stage renal disease (A)The Secretary should determine clinical criteria for dialysis patients to receive increased frequency or duration of dialysis. The Secretary should then examine the feasibility of a multitiered composite rate that would allow different payments based on the frequency and duration of dialysis prescribed, as well as other factors related to adequacy of dialysis. |
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