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 |
|---|---|---|
Revising payment methods and monitoring quality of care in traditional Medicare (M)To provide further protection for the primarily voluntary hospitals with mid-level low-income shares, the minimum value, or threshold, for the low-income share that a hospital must have before payment is made should be set to make 60 percent of hospitals eligible to receive disproportionate share payments. |
|
March 2000 |
Revising payment methods and monitoring quality of care in traditional Medicare (N)HCFA should continue to work with the medical community in developing guidelines for evaluation and management services, minimizing their complexity, and exploring alternative approaches to promote accurate coding of these services. |
|
March 2000 |
Revising payment methods and monitoring quality of care in traditional Medicare (O)HCFA should pilot-test documentation guidelines for evaluation and management services before their implementation, and/or pilot test any alternative method. The agency should continue to work with the medical community in developing the pilot tests, and should ensure adequate time for physician education. |
|
March 2000 |
Revising payment methods and monitoring quality of care in traditional Medicare (P)HCFA should disclose coding edits to physicians and should seek review of the appropriateness of those edits by the medical community. |
|
March 2000 |
Updating payment rates in traditional MedicareThe Congress should not establish a single overall expenditure target that determines payment updates for physicians’ services and ambulatory care facilities. Within existing statutory authority, the Secretary should not establish setting-specific expenditure targets. |
|
March 2000 |
Access to home health services (A)The Secretary should speed the development of regulations that outline home health care coverage and eligibility criteria based on clinical characteristics of beneficiaries. The Secretary should report to the Congress recommending the legislation needed to accomplish the implementation of these regulations. |
|
June 1999 |
Access to home health services (B)The Secretary should use criteria based on clinical characteristics of beneficiaries to monitor use of home health services. |
|
June 1999 |
Access to home health services (C)If the Congress is not confident that the Secretary can implement a prospective payment system for home health services by 2000, then it should explore the feasibility of establishing a process for agencies to exclude a small share of their patients from the aggregate per-beneficiary limits. Such a policy should be implemented in a budget-neutral… Read more » |
|
June 1999 |
Access to home health services (D)The Secretary should establish a national uniform process to ensure that fiscal intermediaries have the training and ability to provide timely and accurate coverage and payment information to home health agencies. |
|
June 1999 |
Access to home health services (E)The Secretary should improve the applicability of the Medicare fee-for-service appeals process for home health users and establish a mechanism for informing beneficiaries about their rights to appeal determinations of noncoverage by home health agencies. |
|
June 1999 |