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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
Hospice services The Congress should update the payment rates for hospice for fiscal year 2013 by 0.5 percent	Post-acute care	March 2012
Inpatient rehabilitation facility services The Congress should eliminate the update to the Medicare payment rates for inpatient rehabilitation facilities in fiscal year 2013.	Post-acute care	March 2012
Long-term care hospital services The Secretary should eliminate the update to the payment rates for long-term care hospitals for fiscal year 2013.	Post-acute care	March 2012
Skilled nursing facility services (1) The Congress should eliminate the market basket update and direct the Secretary to revise the prospective payment system for skilled nursing facilities for 2013. Rebasing payments should begin in 2014, with an initial reduction of 4 percent and subsequent reductions over an appropriate transition until Medicare’s payments are better aligned with providers’ costs.	Post-acute care	March 2012
Skilled nursing facility services (2) The Congress should direct the Secretary to reduce payments to skilled nursing facilities with relatively high risk-adjusted rates of rehospitalization during Medicare-covered stays and be expanded to include a time period after discharge from the facility.	Post-acute care	March 2012
Home health services (1) The Secretary, with the Office of Inspector General, should conduct medical review activities in counties that have aberrant home health utilization. The Secretary should implement the new authorities to suspend payment and the enrollment of new providers if they indicate significant fraud.	Post-acute care	March 2011
Home health services (2) The Congress should direct the Secretary to begin a two-year rebasing of home health rates in 2013 and eliminate the market basket update for 2012.	Post-acute care	March 2011
Home health services (3) The Secretary should revise the home health case-mix system to rely on patient characteristics to set payment for therapy and non-therapy services and should no longer use the number of therapy visits as a payment factor.	Post-acute care	March 2011
Home health services (4) The Congress should direct the Secretary to establish a per episode copay for home health episodes that are not preceded by hospitalization or post-acute care use.	Beneficiaries and coverage Post-acute care	March 2011
Hospice The Congress should update the payment rates for hospice for fiscal year 2012 by 1 percent.	Post-acute care	March 2011