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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

Defining long-term care hospitals (A)

The Congress and the Secretary should define long-term care hospitals by facility and patient criteria that ensure that patients admitted to these facilities are medically complex and have a good chance of improvement. * Facility-level criteria should characterize this level of care by features such as staffing, patient evaluation and review processes, and mix of… Read more »
  • Post-acute care

June 2004

Defining long-term care hospitals (B)

The Secretary should require the Quality Improvement Organizations to review long-term care hospital admissions for medical necessity and monitor that these facilities are in compliance with defining criteria.
  • Post-acute care
  • Quality

June 2004

Ambulatory surgical center services (1)

There should be no update to payment rates for ASC services for fiscal year 2005.
  • Ambulatory care settings

February 2004

Ambulatory surgical center services (2)

The Secretary should revise the ASC payment system so that its relative weights and procedure groups are aligned with those in the outpatient prospective payment system. In addition: * The Congress should require the Secretary to periodically collect ASC cost data at the procedure level to monitor the adequacy of ASC rates, refine the relative… Read more »
  • Ambulatory care settings

February 2004

Ambulatory surgical center services (3)

After the ASC payment system is revised, the Congress should direct the Secretary to replace the current list of approved ASC procedures with a list of procedures that are excluded from payment based on clinical safety standards and whether the service requires an overnight stay.
  • Ambulatory care settings
  • Quality

February 2004

Home health services (1)

The Congress should eliminate the update to payment rates for home health services for 2005.
  • Post-acute care

February 2004

Home health services (2)

The Secretary should continue to monitor access to care, the impact of the payment system on patient selection, and the use of services across post-acute care settings.
  • Post-acute care

February 2004

Hospital inpatient and outpatient services (1)

The Congress should increase payment rates for the inpatient prospective payment system by the projected rate of increase in the hospital market basket index for fiscal year 2005.
  • Hospital

February 2004

Hospital inpatient and outpatient services (2)

The Congress should increase payment rates for the outpatient prospective payment system by the projected rate of increase in the hospital market basket index for calendar year 2005.
  • Hospital

February 2004

Hospital inpatient and outpatient services (3)

The Congress should eliminate the outlier policy under the outpatient prospective payment system.
  • Hospital

February 2004