The Medicare Payment Advisory Commission (MedPAC) and Medicaid and CHIP Payment and Access Commission (MACPAC) have submitted their annual March reports to Congress.
MedPAC Report
MedPAC makes recommendations related to the adequacy of the fee-for-service payments for inpatient and outpatient services at acute-care hospitals, outpatient dialysis, skilled nursing facilities, home health agencies, inpatient rehab facilities, and hospice providers. Additionally, the report includes recommendations related to inpatient psychiatric care, the Medicare Advantage program, and the Medicare prescription drug program.
Recommendations related to disproportionate share hospital (DSH) payments are:
- For 2026, updating the 2025 Medicare base payment rates for acute-care hospitals by the amount specified in current law, plus 1 percent
- Redistributing existing DSH and uncompensated care payments through the Medicare Safety-Net Index, and adding $4 billion to the pool
MedPAC also recommends tying physician pay to the Medicare Economic Index minus one percentage point and removing the lifetime limit for treatment in freestanding psychiatric facilities. The commission also notes that Medicare Advantage plans are expected to cost the federal government $84 billion in 2025.
MACPAC Report
The MACPAC March report to Congress makes recommendations on the Medicaid managed care external quality review (EQR) process, access to home- and community-based services (HCBS), and reducing states’ administrative barriers to providing HCBS services for Medicaid beneficiaries.
Medicaid managed care EQR recommendations include:
- EQR annual technical reports on outcomes data and results from quantitative assessments collected to be published on the CMS website
- Updates to EQR protocols to reduce duplication with other federal reporting requirements
For access to HCBS service, MACPAC recommends CMS issue guidance on how states can use provisional plans of care, including policy and operational considerations. MACPAC also recommends Congress increase renewal periods for HCBS programs operating under Section 1915 waivers from five to 10 years.
Contact Director of Policy Rob Nelb, MPH, at rnelb@essentialhospitals.org or 202.585.0127 with questions.
Author