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 |
|---|---|---|
Long-term care hospital servicesThe Secretary should eliminate the update to the payment rates for long-term care hospitals for fiscal year 2015. |
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March 2014 |
Outpatient dialysis services (1)The Congress should not increase the outpatient dialysis payment rate for calendar year 2015. |
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March 2014 |
Outpatient dialysis services (2)The Congress should direct the Secretary to: * include a measure that assesses poor outcomes related to anemia in the End-Stage Renal Disease Quality Incentive Program. * redesign the low-volume payment adjustment to consider a facility’s distance to the nearest facility. * audit dialysis facilities’ cost report data. |
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March 2014 |
Post-acute care providers: Steps toward broad payment reformsThe Congress should direct the Secretary to implement common patient assessment items for use in home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals by 2016. |
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March 2014 |
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 |
Mandated report: Geographic adjustment of payments for the work of physicians and other health professionalsMedicare payments for work under the fee schedule for physicians and other health professionals should be geographically adjusted. The adjustment should reflect geographic differences across labor markets for physicians and other health professionals. The Congress should allow the geographic practice cost index (GPCI) floor to expire per current law and, because of uncertainty in the… Read more » |
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June 2013 |
Mandated report: Improving Medicare’s payment system for outpatient therapy services (1)The Congress should direct the Secretary to: reduce the certification period for the outpatient therapy plan of care from 90 days to 45 days, and develop national guidelines for therapy services, implement payment edits at the national level based on these guidelines that target implausible amounts of therapy, and use authorities granted by the Patient… Read more » |
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June 2013 |
Mandated report: Improving Medicare’s payment system for outpatient therapy services (2)To avoid caps without exceptions, the Congress should: reduce the therapy cap for physical therapy and speech-language pathology services combined and the separate cap for occupational therapy to $1,270 in 2013. These caps should be updated each year by the Medicare Economic Index. direct the Secretary to implement a manual review process for requests to… Read more » |
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June 2013 |
Mandated report: Improving Medicare’s payment system for outpatient therapy services (3)The Congress should direct the Secretary to: prohibit the use of V codes as the principal diagnosis on outpatient therapy claims, and collect functional status information on therapy users using a streamlined, standardized, assessment tool that reflects factors such as patients’ demographic information, diagnoses, medications, surgery, and functional limitations to classify patients across all therapy… Read more » |
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June 2013 |