MedPAC proposes Medicare benefit reform
Article Thumbnail ImageMarch 12, 2012 -- In a meeting on March 8, the Medicare Payment Advisory Commission (MedPAC) recommended that the U.S. Congress direct the Secretary of Health and Human Services to develop a new fee-for-service benefit design that could include higher patient co-payments for advanced diagnostic imaging services.
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  • The objectives of reforming Medicare's benefit design include reducing beneficiaries' exposure to the risk of unexpectedly high out-of-pocket spending and requiring cost sharing to discourage use of lower-value services, while keeping in mind any effect of the changes on low-income beneficiaries, MedPAC said.

    Among MedPACs recommendations for the reform was the suggestion that co-payments would vary by type of service and provider -- potentially including a higher co-pay for advanced imaging, such as $100 per study, that might make beneficiaries think twice before agreeing to these services.

    Other recommendations included establishing an out-of-pocket maximum, combining the deductible for Medicare Part A and Part B services, implementing a surcharge on supplemental insurance, and secretarial authority to alter cost sharing based on the evidence of the value of the services, MedPAC said.

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