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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

Structuring informed beneficiary choice (B)

The Congress should fund HCFA’s education initiatives adequately and directly through the appropriations process rather than through assessing user fees on Medicare+Choice organizations.

  • Part C (Medicare Advantage)
  • Quality

June 1999

Structuring informed beneficiary choice (C)

The Secretary should develop and evaluate interactive tools that give beneficiaries a framework for understanding their choices and that help them to process information.

  • Quality

June 1999

Structuring informed beneficiary choice (D)

The Secretary should define and regularly update appropriate standard terms for describing Medicare coverage options. HCFA should use these terms in its informational materials, require their use by Medicare+Choice organizations, and encourage their use by medigap policy carriers and others who provide beneficiary information.

  • Part C (Medicare Advantage)
  • Quality

June 1999

Structuring informed beneficiary choice (E)

The Secretary should study the enrollment patterns of beneficiaries, giving particular attention to vulnerable groups, to assess whether their informational needs are adequately met.

  • Quality

June 1999

Structuring informed beneficiary choice (F)

The Secretary should monitor the prevalence of aggressive marketing techniques or abuses, especially toward vulnerable populations, such as frail beneficiaries and those without functional literacy.

  • Quality

June 1999

Changing Medicare’s Payment Systems for Ambulatory Care Facilities (A)

In establishing ambulatory care prospective payment systems in general, the Secretary should: Define the unit of payment for ambulatory care facilities as the individual service, consisting of the primary service that is the reason for the encounter, the ancillary services and supplies integral to it, and limited follow-up care, but not the physicians’ services. The… Read more »

  • Ambulatory care settings

March 1999

Changing Medicare’s Payment Systems for Ambulatory Care Facilities (B)

In establishing ambulatory care prospective payment systems in general, the Secretary should: Use costs of individual services, not groups of services, to calculate the relative weights that apply to ambulatory care prospective payment systems. Relative weights should be calculated consistently across all ambulatory settings.

  • Ambulatory care settings

March 1999

Changing Medicare’s Payment Systems for Ambulatory Care Facilities (C)

In establishing ambulatory care prospective payment systems in general, the Secretary should: Evaluate payment amounts under both the hospital outpatient prospective payment system and the ambulatory surgical center prospective payment system together with practice expense payments for services provided in physicians’ offices under the revised Medicare Fee Schedule to ensure that unwarranted financial incentives that… Read more »

  • Ambulatory care settings

March 1999

Changing Medicare’s Payment Systems for Ambulatory Care Facilities (D)

In establishing ambulatory care prospective payment systems in general, the Secretary should: Study means of adjusting base prospective payment rates for patient characteristics such as age, frailty, comorbidities and coexisting conditions, and other measurable traits.

  • Ambulatory care settings

March 1999

Changing Medicare’s Payment Systems for Ambulatory Care Facilities (E)

In establishing ambulatory care prospective payment systems in general, the Secretary should: Seek legislation to develop and implement a single update mechanism that would link conversion factor updates to volume growth across all ambulatory care services.

  • Ambulatory care settings

March 1999