MedPAC finalizes 2018 payment recommendations for hospital services

The Medicare Payment Advisory Commission today finalized its recommendation that would update payments for hospital inpatient and outpatient services in 2018 as outlined under current law, that is, an estimated 1.85%. In addition, MedPAC finalized recommendations that would require Medicare to add a modifier on claims for all services provided at off-campus stand-alone emergency department facilities. In other sessions today, MedPAC finalized recommendations that would update physician payments in accordance with current law (estimated at 0.5%), provide no update to payments for ambulatory surgery centers, and require Medicare to calculate Medicare Advantage benchmarks using fee-for-service spending data only for beneficiaries enrolled in Parts A and B. MedPAC commissioners also discussed their 2017 agenda related to Part D and drug pricing. The MedPAC staff recommended continuing to focus on changes to the Part D reinsurance threshold, appeals processes, and electronic prior authorization. Commissioners expressed interest in taking on a much broader range of drug pricing issues, including value-based purchasing for drugs; Medicare-negotiation of prices; limits on year-over-year price increases; limits on the drugs Medicare will cover based on value; the role of patient assistance cards and discount coupons; and the issue of over-medication and its impact on broader Medicare spending. The commissioners also discussed ideas for redesigning the quality payment program for physicians and other clinicians mandated by the Medicare Access and CHIP Reauthorization Act. An update on MedPAC’s discussion of post-acute-care issues will be included in tomorrow’s News Now.