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 |
|---|---|---|
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 |
Medicare payment for ambulance services (1)The Congress should: allow the three temporary ambulance add-on policies to expire; direct the Secretary to rebalance the relative values for ambulance services by lowering the relative value of basic life support nonemergency services and increasing the relative values of other ground transports. Rebalancing should be budget neutral relative to current law and maintain payments… Read more » |
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June 2013 |
Medicare payment for ambulance services (2)The Congress should direct the Secretary to: promulgate national guidelines to more precisely define medical necessity requirements for both emergency and nonemergency (recurring and nonrecurring) ground ambulance transport services; develop a set of national edits based on those guidelines to be used by all claims processors; and identify geographic areas and/or ambulance suppliers and providers… Read more » |
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June 2013 |
Ambulatory surgical center servicesThe Congress should eliminate the update to the payment rates for ambulatory surgical centers for calendar year 2014. The Congress should also require ambulatory surgical centers to submit cost data. |
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March 2013 |
Outpatient dialysis servicesThe Congress should not increase the outpatient dialysis bundled payment rate for calendar year 2014. |
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March 2013 |
Ambulatory surgical center services (1)The Congress should update the payment rates for ambulatory surgical centers by 0.5 percent for calendar year 2013. The Congress should also require ambulatory surgical centers to submit cost data. |
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March 2012 |
Ambulatory surgical center services (2)The Congress should direct the Secretary to implement a value-based purchasing program for ambulatory surgical center services no later than 2016. |
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March 2012 |
Outpatient dialysis servicesThe Congress should update the outpatient dialysis payment rate by 1 percent for calendar year 2013. |
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March 2012 |
Ambulatory surgical centersThe Congress should implement a 0.5 percent increase in payment rates for ambulatory surgical center services in calendar year 2012 concurrent with requiring ambulatory surgical centers to submit cost and quality data. |
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March 2011 |