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MedPAC Issues Recommendations to Congress

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At the January meeting, the Medicare Payment Advisory Commission (MedPAC) recommended that Congress increase the rate for hospital inpatient and outpatient prospective payment systems (PPS) by 2 percent in federal fiscal year (FFY) and calendar year (CY) 2020.

The commission also recommended consolidating the Hospital Value-Based Purchasing, Hospital Readmissions Reduction, and Hospital-Acquired Conditions Penalty programs into a new Hospital Value Incentive Program (HVIP). The Inpatient Quality Reporting Program would also be eliminated. The difference between the recommended update and the amount specified under current law would be redirected to the HVIP.

Other recommendations include:

  • Increase the long-term care hospital rate by 2 percent in 2020.
  • Reduce the inpatient rehabilitation facility rate by 5 percent in 2020.
  • Eliminate the FFY 2020 update for skilled-nursing facilities (SNFs), revise the SNF PPS, and annually recalibrate the relative weights of the case-mix groups to maintain alignment of payments and costs.
  • Increase the CY 2019 Medicare payment rates for physician and other health professional services by the amount specified in current law, require nurse practitioners (NPs) and physician assistants (PAs) to bill the Medicare program directly, eliminate “incident to” billing for services they provide, and refine Medicare’s specialty designations for NPs and PAs.
  • Eliminate the CY 2020 update to the Medicare conversion factor for ambulatory surgical centers (ASCs) and require ASCs to report cost data.
  • Reduce FFY 2019 rates for hospice providers by 2 percent.