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Advising the Congress on Medicare issues
MedPAC > Recommendations

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

Payment for pharmacy handling costs in hospital outpatient departments (B)

The Secretary should: * Define a set of handling fee APCs that group drugs, biologicals, and radiopharmaceuticals based on attributes of the products that affect handling costs; * Instruct hospitals to submit charges for those APCs; and * Base payment rates for the handling fee APCs on submitted charges, reduced to costs.
  • Drugs, Devices, and Tests
  • Hospital

June 2005

The Medicare Advantage program (A)

The Congress should eliminate the stabilization fund for regional preferred provider organizations.
  • Part C (Medicare Advantage)

June 2005

The Medicare Advantage program (B)

The Secretary should calculate clinical measures for the fee-for-service program that would permit CMS to compare the fee-for-service program to Medicare Advantage plans.
  • Part C (Medicare Advantage)

June 2005

The Medicare Advantage program (C)

The Congress should clarify that regional plans should submit bids that are standardized for the region’s Medicare Advantage-eligible population.
  • Part C (Medicare Advantage)

June 2005

The Medicare Advantage program (D)

The Congress should remove the effect of payments for indirect medical education from the Medicare Advantage plan benchmarks.
  • Hospital
  • Part C (Medicare Advantage)

June 2005

The Medicare Advantage program (E)

a) The Congress should set the benchmarks that CMS uses to evaluate Medicare Advantage plan bids at 100 percent of the fee-for-service costs. b) At the same time, the Congress should also redirect Medicare’s share of savings from bids below the benchmarks to a fund that would redistribute the savings back to Medicare Advantage plans… Read more »
  • Part C (Medicare Advantage)

June 2005

The Medicare Advantage program (F)

The Congress should put into law the scheduled phase-out of the hold-harmless policy that offsets the impact of risk adjustment on aggregate payments through 2010.
  • Part C (Medicare Advantage)

June 2005

Home health services

The Congress should eliminate the update to payment rates for home health care services for calendar year 2006.
  • Post-acute care

March 2005

Hospital inpatient and outpatient services (1)

The Congress should increase payment rates for the inpatient prospective payment system by the projected increase in the hospital market basket index less 0.4 percent for fiscal year 2006.
  • Hospital

March 2005

Hospital inpatient and outpatient services (2)

The Congress should increase payment rates for the outpatient prospective payment system by the project increase in the hospital market basket index less 0.4 percent for calendar year 2006.
  • Hospital

March 2005