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MedPAC Seeks Rate Increase

Update for 2010

Staff Reporters

According to Modern Healthcare, December 5, 2008, the Medicare Payment Advisory Commission [MedPAC] just drafted recommendations to increase payment rates for inpatient and outpatient services at the full rate of inflation in 2010, concurrent with the implementation of a quality incentives program.

A Non-Specific Market Basket

Although the draft didn’t provide a specific increase for hospitals, the projected market-basket update in 2010 for hospitals is 2.7 percent. MedPAC revisited a proposal it has been trying to get Congress to approve for the past several years: to reduce the indirect medical education (IME) adjustment by 1 percentage point to help finance the quality incentives program for hospitals.

Related Payment Issues

On other payment issues, the commission mulled over a draft recommendation to increase Medicare physician payments by 1.1 percent in 2010, the same increase doctors will receive in 2009, while commissioners also discussed options to make positive payment updates for ambulatory surgery centers contingent upon the submission of cost data to HHS.

Assessment

The draft recommendations will be voted on in January, 2009.

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2 Responses

  1. Lawmakers Express Concerns About IPAB

    Four members of Congress testified this week in the second congressional hearing to examine the Independent Payment Advisory Board (IPAB), and Republicans aren’t the only ones who favor repealing this provision in the healthcare reform law.

    Rep. Phil Roe (R-TN.), a physician, and Sen. John Cornyn (R-TX)—both of whom have introduced legislation to repeal the IPAB—testified on the first panel of witnesses with Reps. Allyson Schwartz (D-PA) and George Miller (D-CA) before the House Energy and Commerce Subcommittee on Health.

    Similar to what the House Budget Committee did at its prior hearing, the health subcommittee explored the purpose of the IPAB, a board of 15 non-elected officials who will have the responsibility of recommending ways to reduce Medicare costs.

    Source: Jessica Zigmond, Modern Healthcare [7/13/11]

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  2. MedPAC

    According to a report by MedPAC. 55% of the 175,000 Medicare telehealth claims paid in calendar year 2014 did not specify an originating site.

    While the absence of an originating site claim doesn’t automatically mean the reimbursements are improper, the MedPAC report did find that 44% of those telehealth claims in 2014 “were associated with beneficiaries living in urban areas,” and one provider was found to have conducted 2,000 telehealth visits in a single year, all from an urban area.

    Source: mHealth Intelligence

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