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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
Skilled nursing facility services (3A) Consistent with previous MedPAC recommendations, the Secretary should develop a new classification system for care in skilled nursing facilities. Because it may take time to develop this system, the Secretary should draw on new and existing research to reallocate payments to achieve a better balance of available resources between the rehabilitation and nonrehabilitation groups. To… Read more »	Delivery system reforms Post-acute care	February 2003
Skilled nursing facility services (3B) If necessary action does not occur within a timely manner, the Congress should provide for a market basket update, less an adjustment for productivity growth of 0.9 percent, for hospital-based skilled nursing facilities to be effective October 1, 2003.	Post-acute care	February 2003
Medicare coverage of surgical technologists when functioning as first surgical assistants The Congress should not expand the list of providers eligible to bill Medicare for first assistant services to include certified surgical technologists.	Physicians and other health professionals	June 2002
Medicare coverage of nonphysician providers of mental health services The Congress should not allow marriage and family therapists, licensed professional counselors, and pastoral counselors to bill Medicare independently for mental health services.	Physicians and other health professionals	June 2002
Medicare coverage of clinical pharmacists’ services The Secretary should assess models for collaborate drug therapy management services in outpatient settings.	Drugs, Devices, and Tests	June 2002
Medicare payment to advanced practice nurses and physician assistants The Congress should increase Medicare payment rates for certified nurse-midwives to 85 percent of the physician fee schedule. The conversion factor for physician services should be adjusted to make this change budget neutral.	Physicians and other health professionals	June 2002
Hospice services (1) The Secretary should evaluate hospice payment rates to ensure they are consistent with the costs of providing appropriate care.	Post-acute care	May 2002
Hospice services (2) The Secretary should research differences in the care and resource needs of hospice patients and determine whether a case-mix adjusted payment system for hospice care is feasible. He also should study ways to establish a high-cost outlier policy.	Post-acute care	May 2002
Accounting for changes in input prices The Secretary should use the wage and benefit proxies that most closely match the training and skill requirements of health care occupations in all input price indexes used for updating payments. In determining index weights, measures specific to the health sector and to occupation categories in which health care plays a major role should be… Read more »	Physicians and other health professionals	March 2002
Home health services (1) The Congress should extend for two years the 10 percent add-on payments for home health services provided in rural areas.	Post-acute care Regional issues	March 2002