MedPAC releases draft recommendations for hospital payment

Group also suggests changes for outpatient physician offices

Inpatient and outpatient reimbursement to hospitals that treat Medicare patients would increase by 1% in fiscal year (FY) 2013, according to draft spending recommendations released Thursday by the Medicare Payment Advisory Commission (MedPAC).

The recommendations also suggested that the HHS secretary be authorized to reduce payments for evaluation and management office visits in hospital outpatient departments to the rate of free-standing physicians' offices.

MedPAC's other recommendations include:

  • Eliminating a market basket increase for skilled nursing facilities (SNFs) in 2013;
  • Changes to a prospective payment system for SNFs in 2013;
  • A "rebase" of Medicare payments to SNFs in 2014, which would include an "initial reduction of 4% and subsequent reductions over an appropriate transition until Medicare's payments are better aligned with providers' costs;"
  • A 0.5% increase in payments for ambulatory surgical center services in 2013; and
  • An overhaul of the sustainable growth rate formula, which determines Medicare physician reimbursements, that would establish a 10-year fee schedule that freezes primary care payment rates and cuts other provider rates by 5.9% for three years before also freezing those payments.

The draft recommendations do not take into account automatic Medicare spending cuts that would take effect in 2013 under the recent budget deal. MedPAC is expected to vote on the final recommendations in January and report them to Congress in March (Norman, CQ HealthBeat, 12/15 [subscription required]; Reichard, CQ HealthBeat, 12/15 [subscription required]).

Next in the Daily Briefing

Let the states decide: HHS passes the buck on essential benefits

Read now

You May Also Like