As the Medicare Payment Advisory Commission (MedPAC) is meeting today (Thursday, September 12th) and tomorrow (Friday, September 13th), Capitol Health Record has prepared the following primer. Information on MedPAC’s public meeting this week is available here.
As part of the Balanced Budget Act of 1997, Congress established an independent 17-member Commission tasked with recommending to Congress changes in Medicare policies. MedPAC is charged with determining Medicare’s payment adequacy for physicians, hospitals, and other providers as well as determining whether Medicare beneficiaries have adequate access to Medicare services.
Does MedPAC have the force of law? MedPAC’s recommendations are not law. Congress must adopt MedPAC’s recommendations in order for them to be fully implemented. However, MedPAC’s recommendations are often influential among policymakers as they develop new legislative proposals.
How does one become a MedPAC Commissioner? The Government Accountability Office (GAO) annually publishes a notice inviting individuals to become a MedPAC Commissioner. GAO’s announcement is generally published in January and nominations are generally due in mid-March of each year. New Commissioners are generally announced in late May or early June each year.
Where can I find more information about MedPAC’s recommendations? Each year MedPAC publishes at least two reports. MedPAC’s March report contains recommendations on payment changes on a range of issues. In June MedPAC publishes a report providing analysis on other policy issues and additional information on other recommendations. (More information on MedPAC’s March 2013 report is available here and information on its June 2013 report is available here.) In addition, MedPAC generally submits comments on the Centers for Medicare & Medicaid Services’ (CMS’) proposed rules implementing Medicare payment policies. All of MedPAC’s reports and comment letters are available on its website (www.medpac.gov).
Does MedPAC provide recommendations on all health care issues? No. MedPAC is limited to providing recommendations regarding the Medicare program. MedPAC can, and does, make recommendations to address issues arising with so-called “dual eligibles” (e.g., individuals who are eligible for both the Medicare and Medicaid programs). However, MedPAC generally does not provide recommendations solely related to other payers or services (like the Medicaid program or employer-sponsored health care).
How does MedPAC differ from the Independent Payment Advisory Board (IPAB)? MedPAC makes recommendations to improve the Medicare program. IPAB, if convened, would be limited to making recommendations to limit the per capita rate of growth in Medicare spending. In other words, MedPAC can make recommendations to add policies and services to Medicare (regardless of whether these new policies result in additional federal spending). IPAB can only make recommendations to cut Medicare spending.