Here are five key Medicare issues from MedPAC’s June report.
1. MedPAC recommended the two-midnight rule be withdrawn.
2. The commission made a number of recommendations to Congress regarding short inpatient stays. The commission recommended that recovery audit contractors focus reviews of short inpatient stays on hospitals with the highest rates of this type of stay. The commission also recommended RACs’ contingency fees be tied to their claim denial overturn rate, and that the RAC look-back period be shorter than the Medicare rebilling period for short inpatient stays.
3. The commission recommended that Congress require acute care hospitals to notify beneficiaries placed in outpatient observation status that their observation status may affect their financial liability for skilled nursing facility care.
4. MedPAC recommended policies be better aligned across Medicare’s three payment models: fee-for-service, Medicare Advantage plans and accountable care organizations.
5. MedPAC made recommendations on payment policies for Part B drugs.”Given the high level of Medicare payments relative to 340B hospitals’ drug acquisition costs, policymakers might consider whether Medicare should pay less than average sales price + 6 percent for Part B drugs purchased by those hospitals,” the report stated. Alternatively, if the payment rate does not change, beneficiaries’ cost sharing for 340B drugs could be reduced, according to the report.
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