MedPAC’s publications are in the public domain and do not require explicit permission from the agency for use or reproduction. Any reproduction should ensure that text and graphics (including tables, figures, charts, etc) are reproduced in their entirety, and not modified in such a way that the content is altered. Such material should be properly cited (for example: Medicare Payment Advisory Commission. 2021. Report to the Congress: Medicare and the health care delivery system. Washington, DC: MedPAC).