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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 The Congress should eliminate the market basket updates for 2018 and 2019 and direct the Secretary to revise the prospective payment system (PPS) for skilled nursing facilities. In 2020, the Secretary should report to the Congress on the impacts of the reformed PPS and make any additional adjustments to payments needed to more closely align… Read more »	Delivery system reforms Post-acute care	March 2017
Mandated report: Developing a unified system for post-acute care The Commission has voted to forward to the Congress the report on the unified post-acute care payment system required by the Improving Medicare Post-Acute Care Transformation Act of 2014.	Post-acute care	June 2016
Home health care services The Congress should direct the Secretary to eliminate the payment update for 2017 and implement a two-year rebasing of the payment system beginning in 2018 for home health care services. The Congress should direct the Secretary to revise the prospective payment system to eliminate the use of therapy visits as a factor in payment determinations,… Read more »	Post-acute care	March 2016
Hospice services The Congress should eliminate the update to the hospice payment rates for fiscal year 2017.	Post-acute care	March 2016
Inpatient rehabilitation facility services (1) The Congress should eliminate the update to the Medicare payment rate for inpatient rehabilitation facilities in fiscal year 2017.	Post-acute care	March 2016
Inpatient rehabilitation facility services (2) The Secretary should conduct focused medical record review of inpatient rehabilitation facilities that have unusual patterns of case mix and coding.	Post-acute care	March 2016
Inpatient rehabilitation facility services (3) The Secretary should expand the inpatient rehabilitation facility outlier pool to redistribute payments more equitably across cases and providers.	Post-acute care	March 2016
Long-term care hospital services The Secretary should eliminate the update to the payment rates for long-term care hospitals for fiscal year 2017.	Post-acute care	March 2016
Skilled nursing facility services The Congress should eliminate the market basket update for skilled nursing facilities for fiscal years 2017 and 2018 and direct the Secretary to revise the prospective payment system (PPS) for skilled nursing facilities. In 2019, the Secretary should report to the Congress on the effects of the reformed PPS and make any additional adjustments to… Read more »	Delivery system reforms Post-acute care	March 2016
Hospital short-stay policy issues (3) The Congress should revise the skilled nursing facility three-inpatient-day hospital eligibility requirement to allow for up to two outpatient observation days to count toward meeting the criterion.	Hospital Post-acute care	June 2015