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 |
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Rebalancing Medicare Advantage benchmark policyThe Congress should replace the current Medicare Advantage (MA) benchmark policy with a new MA benchmark policy that applies: |
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June 2021 |
Replacing the Medicare Advantage quality bonus programThe Congress should replace the current Medicare Advantage (MA) quality bonus program with a new MA value incentive program that: scores a small set of population-based measures; evaluates quality at the local market level; uses a peer-grouping mechanism to account for differences in enrollees’ social risk factors; establishes a system for distributing rewards with no… Read more » |
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June 2020 |
Ensuring the accuracy and completeness of Medicare Advantage encounter dataThe Congress should direct the Secretary to establish thresholds for the completeness and accuracy of Medicare Advantage (MA) encounter data and: |
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June 2019 |
The Medicare Advantage program: Status report (1)For Medicare Advantage contract consolidations involving different geographic areas, the Secretary should: for any consolidations effective on or after January 1, 2018, require companies to report quality measures using the geographic reporting units and definitions as they existed prior to consolidation, and determine star ratings as though the consolidations had not occurred, and maintain the… Read more » |
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March 2018 |
The Medicare Advantage program: Status report (2)The Secretary should: establish geographic areas for Medicare Advantage quality reporting that accurately reflect health care market areas, and calculate star ratings for each contract at the geographic level for public reporting and for the determination of quality bonuses. |
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March 2018 |
Status report on the Medicare Advantage programThe Secretary should calculate Medicare Advantage benchmarks using fee-for-service spending data only for beneficiaries enrolled in both Part A and Part B. |
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March 2017 |
The Medicare Advantage program: Status report (1)The Congress should eliminate the cap on benchmark amounts and the doubling of the quality increases in specified counties. |
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March 2016 |
The Medicare Advantage program: Status report (2)The Congress should direct the Secretary to: develop a risk adjustment model that uses two years of fee-for-service (FFS) and Medicare Advantage (MA) diagnostic data and does not include diagnoses from health risk assessments from either FFS or MA, and then apply a coding adjustment that fully accounts for the remaining differences in coding between… Read more » |
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March 2016 |
The Medicare Advantage program: Status report (1)The Congress should direct the Secretary to determine payments for employer group Medicare Advantage plans in a manner more consistent with the determination of payments for comparable non-employer plans. |
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March 2014 |
The Medicare Advantage program: Status report (2)The Congress should include the Medicare hospice benefit in the Medicare Advantage benefits package beginning in 2016. |
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March 2014 |