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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
Skilled nursing facility services The Congress should eliminate the update to payment rates for skilled nursing facility services for fiscal year 2010.	Post-acute care	February 2009
A revised prospective payment system for skilled nursing facilities (A) The Congress should require the Secretary to revise the skilled nursing facility prospective payment system by: * Adding a separate nontherapy ancillary component, * Replacing the therapy component with one that establishes payments based on predicted patient care needs, and * Adopting an outlier policy	Delivery system reforms Post-acute care	June 2008
A revised prospective payment system for skilled nursing facilities (B) The Secretary should direct skilled nursing facilities to report more accurate diagnostic and service-use information by requiring that: * Claims include detailed diagnosis information and dates of service, * Services furnished since admission to the skilled nursing facility be recorded separately in the patient assessment, and * Skilled nursing facilities report their nursing costs in… Read more »	Post-acute care	June 2008
Home health services The Congress should eliminate the update to payment rates for home health care services for calendar year 2009.	Post-acute care	February 2008
Inpatient rehabilitation facility services The update to the payment rates for inpatient rehabilitation facility services should be eliminated for fiscal year 2009.	Post-acute care	February 2008
Long-term care hospital services The Secretary should update payment rates for long-term care hospitals for rate year 2009 by the projected rate of increase in the rehabilitation, psychiatric, and long-term care hospital market basket index less the Commission’s adjustment for productivity growth.	Post-acute care	February 2008
Skilled nursing facility services (1) The Congress should eliminate the update to payment rates for skilled nursing facility services for fiscal year 2009.	Post-acute care	February 2008
Skilled nursing facility services (2) The Congress should establish a quality incentive payment policy for skilled nursing facilities in Medicare.	Delivery system reforms Post-acute care Quality	February 2008
Skilled nursing facility services (3) To improve quality measurement for skilled nursing facilities, the Secretary should: * Add the risk-adjusted rates of potentially avoidable rehospitalizations and community discharge to its publicly reported post-acute care quality measures; * Revise the pain, pressure ulcer, and delirium measures currently report on CMS’s Nursing Home Compare website; and * Require skilled nursing facilities to… Read more »	Post-acute care Quality	February 2008
Home health services The Congress should eliminate the update to payment rates for home health care services for calendar year 2008.	Post-acute care	March 2007