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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 For fiscal year 2021, the Congress should eliminate the update to the fiscal year 2020 Medicare base payment rates for skilled nursing facilities.	Post-acute care	March 2020
Ensuring the accuracy and completeness of Medicare Advantage encounter data The Congress should direct the Secretary to establish thresholds for the completeness and accuracy of Medicare Advantage (MA) encounter data and:	Part C (Medicare Advantage)	June 2019
Issues in Medicare beneficiaries’ access to primary care (1) The Congress should require advanced practice registered nurses and physician assistants to bill the Medicare program directly, eliminating “incident to” billing for services they provide.	Physicians and other health professionals	June 2019
Issues in Medicare beneficiaries’ access to primary care (2) The Secretary should refine Medicare’s specialty designations for advanced practice registered nurses and physician assistants.	Physicians and other health professionals	June 2019
Options for slowing the growth of Medicare fee-for-service spending for emergency department services The Secretary should develop and implement a set of national guidelines for coding hospital emergency department visits under the outpatient prospective payment system by 2022.	Hospital	June 2019
Ambulatory surgical center services The Congress should eliminate the calendar year 2020 update to the Medicare conversion factor for ambulatory surgical centers. The Secretary should require ambulatory surgical centers to report cost data.	Ambulatory care settings	March 2019
Home health care services For 2020, the Congress should reduce the calendar year 2019 Medicare base payment rate for home health agencies by 5 percent.	Post-acute care	March 2019
Hospice services For 2020, the Congress should reduce the fiscal year 2019 Medicare base payment rates for hospice providers by 2 percent.	Post-acute care	March 2019
Hospital inpatient and outpatient services The Congress should: Replace Medicare’s current hospital quality programs with a new hospital value incentive program (HVIP) that: includes a small set of population-based outcome, patient experience, and value measures; scores all hospitals based on the same absolute and prospectively set performance targets; accounts for differences in patients’ social risk factors by distributing payment adjustments… Read more »	Hospital Quality	March 2019
Inpatient rehabilitation facility services For 2020, the Congress should reduce the fiscal year 2019 Medicare base payment rate for inpatient rehabilitation facilities by 5 percent. Additionally, the Commission reiterates its March 2016 recommendations on the inpatient rehabilitation facility prospective payment system.	Post-acute care	March 2019