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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
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
Using incentives to improve the quality of care in Medicare The Secretary should conduct demonstrations to evaluate provider payment differentials and structures that reward and improve quality.	Delivery system reforms Quality	June 2003
Quality of care in rural areas (A) The Secretary should require the peer review organizations to include rural populations and providers when carrying out their quality improvement activities.	Quality Regional issues	June 2001
Quality of care in rural areas (B) MedPAC reiterates its June 2000 recommendation that the Congress should require the Secretary to survey at least one-third of each facility type annually to certify compliance with the conditions of participation.	Quality	June 2001
Improving quality assurance for institutional providers (A) The Secretary should require providers participating in Medicare to report a minimum, core set of data needed to generate standardized, evidence-based measures of quality and other dimensions of facility performance.	Quality	June 2000
Improving quality assurance for institutional providers (B) To strengthen the evidence basis of Medicare’s conditions of participation, the Secretary should support additional research on the relationship between health care outcomes and both structural characteristics and processes of care.	Quality	June 2000
Improving quality assurance for institutional providers (C) The Congress should mandate the Secretary to review and update the conditions of participation on a specific periodic basis and should require the use of negotiated rulemaking to do so.	Quality	June 2000
Improving quality assurance for institutional providers (E) The Congress should require that the Secretary annually survey at least one-third of each facility type to certify compliance with the conditions of participation. The Secretary should also monitor facilities’ compliance with conditions of participation on an ongoing basis.	Quality	June 2000
Improving quality assurance for institutional providers (F) The Congress should assure that the federal appropriations process does not impede states’ abilities to fund Medicare and Medicaid survey and certification activities.	Quality	June 2000
Improving quality assurance for institutional providers (G) State survey agencies should use health care quality measures and other measures of facility performance to: * Determine which facilities to survey more and less frequently, * Target specific issues or quality concerns for focused attention in the survey process, and Monitor facility performance between inspections.	Quality	June 2000