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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
Options for slowing the growth of Medicare fee-for-service spending for emergency department services The Secretary should develop and implement a set of national guidelines for coding hospital emergency department visits under the outpatient prospective payment system by 2022.	Hospital	June 2019
Hospital inpatient and outpatient services The Congress should: Replace Medicare’s current hospital quality programs with a new hospital value incentive program (HVIP) that: includes a small set of population-based outcome, patient experience, and value measures; scores all hospitals based on the same absolute and prospectively set performance targets; accounts for differences in patients’ social risk factors by distributing payment adjustments… Read more »	Hospital Quality	March 2019
Using payment to ensure appropriate access to and use of hospital emergency department services (1) The Congress should: allow isolated rural stand-alone emergency departments (more than 35 miles from another emergency department) to bill standard outpatient prospective payment system facility fees and provide such emergency departments with annual payments to assist with fixed costs.	Hospital Regional issues	June 2018
Using payment to ensure appropriate access to and use of hospital emergency department services (2) The Congress should reduce Type A emergency department rates by 30 percent for off-campus stand-alone emergency departments that are within six miles of an on-campus hospital emergency department.	Hospital Regional issues	June 2018
Hospital inpatient and outpatient services For 2019, the Congress should update the 2018 Medicare base payment rates (inpatient and outpatient) for acute care hospitals by the amount determined under current law.	Hospital	March 2018
Hospital inpatient and outpatient services (1) The Secretary should require hospitals to add a modifier on claims for all services provided at off-campus stand-alone emergency department facilities.	Hospital	March 2017
Hospital inpatient and outpatient services (2) The Congress should update the inpatient and outpatient payments by the amounts specified in current law	Hospital	March 2017
Hospital inpatient and outpatient services The Congress should direct the Secretary of the Department of Health and Human Services to: update inpatient and outpatient payments by the amount specified in current law; reduce Medicare payment rates for 340B hospitals’ separately payable Part B drugs by 10 percent of the average sales price; direct the program savings from reducing Part B… Read more »	Drugs, Devices, and Tests Hospital	March 2016
Hospital short-stay policy issues (1) The Secretary should: direct recovery audit contractors (RACs) to focus reviews of short inpatient stays on hospitals with the highest rates of this type of stay, modify each RAC’s contingency fees to be based, in part, on its claim denial overturn rate, ensure that the RAC look-back period is shorter than the Medicare rebilling period… Read more »	Hospital	June 2015
Hospital short-stay policy issues (2) The Secretary should evaluate establishing a penalty for hospitals with excess rates of short inpatient stays to substitute, in whole or in part, for recovery audit contractor review of short inpatient stays.	Hospital	June 2015