The Medicare Payment Advisory Commission (MedPAC) released its June 2023 report to Congress on Medicare payment policy on June 15. This report contained several recommendations including aligning fee-for-service payment rates across ambulatory settings, Part B drug pricing, and the Medicare wage index system. Annually, the commission releases statutorily required reports in March and June that include recommendations for updates to the Medicare program.
The commission recommended Congress align payment rates across ambulatory settings for selected services that are safe and appropriate to provide in all settings without posing a risk to access. Additionally, the commission recommended three policies related to Part B drug pricing, including capping the Medicare payment rates for certain drugs, allowing Medicare to use reference pricing to set average sales price- (ASP-) based payment rates for groups of drugs and biologics with similar health effects, and reducing add-on payments for Part B drugs based on ASP or eliminating add-on payments for those paid using wholesale acquisition costs. Lastly, the commission recommended that Medicare’s existing wage index statute be repealed, including exceptions, requiring a new wage index system to be phased in. The commission recommended that the new wage index system use all-employer occupation-level wage data, reflect local differences in wages between and within areas, and smooth wage index differences across adjacent local areas.