MedPAC held its April 2023 public meeting on April 13-14, its last of the 2022-2023 cycle. During the meeting, MedPAC discussed and voted on recommendations reforming Medicare’s wage index systems and aligning fee-for-service payment rates across ambulatory settings. These recommendations will appear in its June 2023 Report to Congress.

MedPAC is recommending that Congress repeals the current wage index statutes and direct the Secretary of Health and Human Services to phase in a new system. For site-neutral payments, MedPAC is recommending that Congress aligns payment rates across ambulatory settings for services that are safe to provide in all settings.

Commissioners voted in favor of both recommendations, although one abstained from voting on the site-neutral payment recommendation.

Why it matters: MedPAC serves as a non-partisan legislative branch agency that provides Congress with analysis and policy advice related to the Medicare program. By law, CMS calculates the wage index, which is used for all PPSs, by surveying the wages and wage-related costs of IPPS hospitals, so any change to the IPPS wage index methodology will impact the Hospital Outpatient Prospective Payment System (HOPPS).  Past MedPAC reports indicate that site-neutral payment reforms could apply to radiation therapy services.

Go deeper on the recommendations.