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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

Improving payment for inpatient hospital care in rural areas (A)

The Congress should require that rural referral centers’ wages exceed the average wage in their area to quality for geographic reclassification, but these facilities should retain their waiver from the proximity rule.

  • Hospital
  • Regional issues

June 2001

Improving payment for inpatient hospital care in rural areas (B)

The Congress should require the Secretary to develop a graduated adjustment to the rates used in the inpatient prospective payment system for hospitals with low overall volumes of discharges. This adjustment should only apply to hospitals that are more than a specified number of miles from another facility providing inpatient care, with appropriate exceptions for… Read more »

  • Hospital
  • Regional issues

June 2001

Improving payment for inpatient hospital care in rural areas (C)

In fiscal year 2002, the Secretary should implement fully the policy of excluding from the hospital wage index salaries and hours for teaching physicians, residents, and certified registered nurse anesthetists.

  • Hospital

June 2001

Improving payment for inpatient hospital care in rural areas (D)

To ensure accurate input-price adjustments in Medicare’s prospective payment systems, the Secretary should reevaluate current assumptions about the proportions of providers’ costs that reflect resources purchased in local and national markets.

  • Hospital

June 2001

Improving payment for inpatient hospital care in rural areas (E)

The Congress should raise the cap on the disproportionate share add-on a rural hospital can receive from 5.25 percent to 10 percent.

  • Hospital

June 2001

Improving payment for inpatient hospital care in rural areas (F)

The Congress should revise the target cap for inpatient psychiatric facilities in a way that better addresses differences among them.

  • Hospital

June 2001

Accounting for new technology in hospital prospective payment systems (A)

In the outpatient payment system, pass-through payments for specific technologies should be made only when a technology is new or substantially improved and adds substantially to the cost of care in an ambulatory payment classification group.

  • Drugs, Devices, and Tests
  • Hospital

March 2001

Accounting for new technology in hospital prospective payment systems (B)

In the outpatient payment system, the Secretary should develop formalized procedures for expeditiously assigning codes, updating relative weights, and investigating the need for service classification changes to recognize the costs of new and substantially improved technologies.

  • Delivery system reforms
  • Hospital

March 2001

Accounting for new technology in hospital prospective payment systems (C)

Pass-through payments in the outpatient payment system should be made on a budget-neutral basis and the costs of new or substantially improved technologies should be factored into the update to the outpatient conversion factor.

  • Drugs, Devices, and Tests
  • Hospital

March 2001

Accounting for new technology in hospital prospective payment systems (E)

For the inpatient payment system, the Secretary should develop formalized procedures for expeditiously assigning codes, updating relative weights, and investigating the need for patient classification changes to recognize the costs of new and substantially improved technologies.

  • Delivery system reforms
  • Hospital

March 2001