Medicare Payment Advisory Commission

MedPAC to Congress: Cut Payments to Freestanding Emergency Facilities

The Medicare Payment Advisory Commission has urged Congress to reduce Medicare payments to freestanding emergency departments 30 percent. The recommendation, approved by MedPAC earlier this month and to be included in its June report to Congress, notes that such facilities have a lower cost structure because they typically lack some of the equipment, personnel, and standby capabilities of hospital ERs.  In making its recommendation, MedPAC also noted that freestanding ERs typically treat patients whose conditions are not as severe as hospital ERs and tend to be located in areas that already have adequate access to hospital ERs. While MedPAC’s recommendations [...]

2018-04-17T13:33:12-04:00April 17, 2018|hospitals, Medicare regulations, MedPAC|

MedPAC Meets

The Medicare Payment Advisory Commission met last week in Washington, D.C. to address a number of Medicare reimbursement-related issues. Among the subjects on MedPAC’s agenda were: using payments to ensure appropriate access to and use of hospital emergency department services uniform outcome measures for post-acute care applying MedPAC’s principles for measuring quality: hospital quality incentives Medicare coverage policy and use of low-value care long-term issues confronting Medicare accountable care organizations managed care plans for dual-eligible beneficiaries While MedPAC’s policy and payment recommendations are not binding on Congress or the administration, its views are respected and influential and often become the [...]

MedPAC Issues 2018 Report to Congress

The Medicare Payment Advisory Commission has issued its 2018 report and recommendations to Congress. The report includes MedPAC’s recommendations for next year’s Medicare fee-for-service payments; a review of the Medicare Advantage and Medicare Part D programs, with recommendations; and a report telehealth required by the 21st Century Cures Act. For Medicare fee-for-service rates, MedPAC proposes: the inpatient and outpatient rate increases, physician and other health professional rate increases, and outpatient dialysis increase included under current law no increase for ambulatory surgical centers, long-term-care hospitals, and hospice providers no rate increase for skilled nursing facilities a five percent reduction of payments [...]

2018-03-21T06:00:04-04:00March 21, 2018|Medicare, MedPAC|

Readmissions Program Working; Expansion in Order?

The Medicare hospital readmissions reduction program is working, according to the Medicare Payment Advisory Commission. And it may even be worth expanding to additional medical conditions, MedPAC members believe. According to MedPAC, hospital readmissions among patients with medical conditions covered by the readmissions reduction program have declined faster than readmissions among patients with medical conditions not covered by the program, suggesting that expanding the program to additional medical conditions could lead to an even greater reduction in the number of avoidable Medicare-covered readmissions. Learn more about changes in the readmission rate since the readmissions reduction program was introduced and whether [...]

2018-03-07T06:00:23-05:00March 7, 2018|Medicare, Medicare regulations, MedPAC|

MedPAC Meets

The Medicare Payment Advisory Commission, which advises Congress on Medicare payment issues, met last week in Washington, D.C. Among the issues on MedPAC’s agenda were: paying for sequential stays in a unified Medicare payment system for post-acute care encouraging Medicare beneficiaries to use higher-quality post-acute care providers using payment policy to ensure appropriate access to and use of hospital emergency department services the Centers for Medicare & Medicaid Services’ financial alignment demonstration for dual-eligible beneficiaries the effectiveness of the Medicare hospital readmissions reduction program population-based quality measures such as preventable admissions and home and community days Go here, to MedPAC’s [...]

Hospitals, Trade Groups Differ on Supervision Requirements

According to provider representatives and trade groups, the requirement that physicians supervise the administration of outpatient therapeutic services to Medicare patients in critical access and small rural hospitals is onerous and could limit patient access to such services. The people who run those hospitals don’t agree. That is the conclusion reached by the Medicare Payment Advisory Commission, which looked into the matter after Congress overturned a Centers for Medicare & Medicaid Services supervision requirement in the 21st Century Cures Act because, as MedPAC observed, CAH and rural hospital representatives…expressed concerns that, because they have difficulty recruiting physicians to practice in [...]

2017-12-12T06:00:08-05:00December 12, 2017|Medicare, Medicare regulations|

MedPAC Meets

The agency that advises Congress on Medicare payment issues met in Washington, D.C. last week. At that meeting, members of the Medicare Payment Advisory Commission discussed a number of Medicare payment issues, including: refining an alternative to the merit-based incentive payment system (MIPS) improving incentives in the emergency debarment payment system rebalancing the physician fee schedule towards primary care increasing the equity of payments within each post-acute-care setting principles for evaluating the expansion of Medicare’s coverage of telehealth services Find the issue briefs and presentations used during the meeting to guide these discussions here, on MedPAC’s web site.

2017-11-07T06:00:47-05:00November 7, 2017|MedPAC|

MedPAC Meets

The independent agency that advises Congress and the administration on Medicare payment policies met last week in Washington, D.C. Among the issues discussed at the meeting of the Medicare Payment Advisory Commission were: the merit-based incentive payment system a unified payment system for post-acute care telehealth a redesign of Medicare’s hospital value incentive program Find the presentations and issue briefs for these subjects and others discussed at the MedPAC meeting here, on MedPAC’s web site.

2017-10-11T06:00:23-04:00October 11, 2017|Medicare, MedPAC|

MedPAC Meets

Members of the Medicare Payment Advisory Commission met last week in Washington, D.C. Among the issues they discussed during their two days of meetings were Medicare coverage policy, Medicare coverage of telehealth services, pharmacy benefit managers and specialty pharmacies, and physician supervision requirements in critical access and small rural hospitals. Go here to see the issue briefs and presentations that were discussed during the meeting.

2017-09-13T06:00:10-04:00September 13, 2017|Medicare, MedPAC|

MedPAC Comments on Proposed Physician Fee Schedule

The Medicare Payment Advisory Commission has written to the Centers for Medicare & Medicaid Services to convey its views on CMS’s proposed revisions to Medicare physician payment policies for 2018. Among the issues MedPAC addresses in its comment letter are proposed payments to physicians for nonexcepted items and services provided in nonexcepted off-campus provider-based hospital departments, the Medicare shared savings program, and the Medicare diabetes prevention program. See CMS’s comment letter here.  

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