MedPac Approves Pay Increase Recommendations for Hospitals, Physicians

January 2017 ~

The Medicare Payment Advisory Commission (MedPAC), on January 13 in a unanimous vote,  approved recommendations calling for increasing payments to health care providers in fiscal year (FY) 2018.

The finalized recommendation, to be included in its March report to Congress, would update payments for hospital inpatient and outpatient services in 2018 as outlined under current law, that is, an estimated 1.85% and about 0.5% for physician payments.

In their sessions, MedPAC commissioners finalized recommendations regarding:

  • Hospital, Physician Payment Recommendations
    • Request for Medicare to be required to include a modifier on claims for services provided at off-site emergency departments (EDs) in an effort to help track spending on such care, as well as to determine whether standalone EDs unfairly benefit from an exemption to site-neutral payments.
    • Request for NO FY 2018 payment update for ambulatory surgical centers, skilled nursing facilities, hospices, or long-term care hospitals.
    • Request for modest cuts to FY 2018 payments to home health agencies and inpatient rehabilitation facilities.
  • Medicare Advantage (MA) Payment Recommendations
    • Request for policymakers to change the formula used to calculate payment rates for MA plans.
    • Request for the HHS secretary to modify the formula to account only for fee-for-service spending data on beneficiaries enrolled in both Part A and Part B.
  • Other Proposed Recommendations
    • Calls for continued focus on changes to Medicare Part D’s:
      • Appeals process;
      • Electronic prior authorization requirements; and
      • Reinsurance programs.

MedPAC commissioners also discussed a desire to pay closer attention to drug pricing issues as well as ideas for redesigning the quality payment program for physicians and other clinicians mandated by the Medicare Access and CHIP Re-authorization Act.


Source(s): American Health Line; Modern Healthcare; AHA News; Modern Healthcare;