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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

Managed care for frail Medicare beneficiaries: payment methods and program standards (H)

The Commission will await results from the Secretary’s demonstration of for-profit entities in the Program of All-Inclusive Care for the Elderly before making a recommendation on allowing them to participate.

  • Part C (Medicare Advantage)

June 1999

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 (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

Medicare+Choice: A Program in Transition (A)

It is too soon to tell whether recent departures from the Medicare managed care program stem from systematic problems with the level or distribution of payment. The Commission plans to monitor and analyze the characteristics of departing plans and the areas they leave and consider general patterns of organization participation, benefits offered, and enrollment. Accordingly,… Read more »

  • Part C (Medicare Advantage)

March 1999

Medicare+Choice: A Program in Transition (B)

The Secretary should continue to work with organizations offering plans and other interested parties to identify specific regulations or other program policies for which changes, delays in implementation, or administrative flexibility might reduce the burden of compliance without compromising the objectives of the Medicare+Choice program.

  • Part C (Medicare Advantage)

March 1999

Medicare+Choice: A Program in Transition (C)

As quickly as feasible, the Secretary should develop the capability to use diagnosis data from all sites of care for risk adjustment.

  • Part C (Medicare Advantage)

March 1999

Medicare+Choice: A Program in Transition (D)

The Secretary’s plan to phase in the interim risk adjustment system- with a method that uses a weighted blend of the payment amounts that would apply under the interim system and those that would apply under the current system- is sound. The weight on the interim payment amounts should be back-end loaded. That is, the… Read more »

  • Delivery system reforms
  • Part C (Medicare Advantage)

March 1999

Medicare+Choice: A Program in Transition (E)

The Congress should move the deadline for the adjusted community rate proposal submission to later in the year to allow organizations to include more of their cost information and more details of Medicare payment methods in their projections.

  • Part C (Medicare Advantage)

March 1999

Medicare+Choice: A Program in Transition (F)

Medicare+Choice organizations should continue to have the flexibility to tailor their benefit packages within their service areas as long as Medicare payments vary by county within a service area. Without this flexibility, organizations may withdraw from counties with lower payments, reducing beneficiary access to new options.

  • Part C (Medicare Advantage)

March 1999