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In June, the Medicare Payment Advisory Commission (MedPAC) released a report to Congress. MedPAC is a 17-member independent congressional agency established in 1997 to advise Congress on Medicare issues, which it does primarily through reports issued in March and June each year. Congress is not obligated to accept MedPAC’s recommendations, but the reports often shape congressional debates and actions. This article focuses on five of the subject areas discussed in the latest report.

Medicare Payments Across Ambulatory Settings

MedPAC expressed concern that Medicare payment rates vary widely for the same ambulatory (outpatient) services in different medical settings, such as physicians’ offices, hospital outpatient departments (OPDs) and ambulatory surgical centers (ASCs). This anomaly has caused many hospitals and physicians, for example, to join forces to take advantage of it. It may not last long. “If the same service can be safely provided in different settings, a prudent purchaser should not pay more for that service in one setting than in another,” the report stated.

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