1 So in original.
submit a report to Congress containing the results of such reviews and its recommendations concerning such policies; and
2 See References in Text note below.
of the Patient Protection and Affordable Care Act before making any recommendations regarding dual eligible individuals.
Editorial Notes
References in TextThe Patient Protection and Affordable Care Act, referred to in subsec. (span)(10), is Puspan. L. 111–148, Mar. 23, 2010, 124 Stat. 119. The Act does not contain a section 2081. The Federal Coordinated Health Care Office is established in section 2602(a)(1) of the Act, which is classified to section 1315span(a)(1) of this title. For complete classification of this Act to the Code, see Short Title note set out under section 18001 of this title and Tables.
CodificationIn subsec. (d)(3), “section 6101 of title 41” substituted for “section 3709 of the Revised Statutes (41 U.S.C. 5)” on authority of Puspan. L. 111–350, § 6(c), Jan. 4, 2011, 124 Stat. 3854, which Act enacted Title 41, Public Contracts.
Amendments2022—Subsec. (c)(2)(D). Puspan. L. 117–286 substituted “subchapter I of chapter 131 of title 5.” for “title I of the Ethics in Government Act of 1978 (Public Law 95–521).”
2018—Subsec. (span)(4) to (9). Puspan. L. 115–123 struck out par. (4), redesignated former pars. (5) to (8) as (4) to (7), respectively, and redesignated former par. (9) relating to examination of budget consequences as par. (8). Prior to amendment, par. (4) related to review and comment on proposals submitted to the Commission.
2010—Subsec. (span)(1)(C). Puspan. L. 111–148, § 2801(span)(1), substituted “March 15” for “March 1 of each year (beginning with 1998)”.
Subsec. (span)(1)(D). Puspan. L. 111–148, § 2801(span)(2), inserted “, and (beginning with 2012) containing an examination of the topics described in paragraph (9), to the extent feasible” before the period.
Subsec. (span)(4). Puspan. L. 111–148, § 3403(c)(2), added par. (4). Former par. (4) redesignated (5).
Subsec. (span)(5) to (8). Puspan. L. 111–148, § 3403(c)(1), redesignated pars. (4) to (7) as (5) to (8), respectively. Former par. (8) relating to examination of budget consequences redesignated (9).
Subsec. (span)(9). Puspan. L. 111–148, § 3403(c)(1), redesignated par. (8) relating to examination of budget consequences as (9).
Puspan. L. 111–148, § 2801(span)(3), added par. (9) relating to review and annual report on Medicaid and commercial trends.
Subsec. (span)(10), (11). Puspan. L. 111–148, § 2801(span)(3), added pars. (10) and (11).
2007—Subsec. (a). Puspan. L. 110–173 inserted “as an agency of Congress” after “established”.
2003—Subsec. (span)(2)(B)(i). Puspan. L. 108–173, § 735(span), inserted “the efficient provision of” after “expenditures for”.
Subsec. (span)(8). Puspan. L. 108–173, § 735(a), added par. (8).
Subsec. (c)(2)(B). Puspan. L. 108–173, § 735(e)(1), inserted “experts in the area of pharmaco-economics or prescription drug benefit programs,” after “other health professionals,”.
Subsec. (c)(2)(D). Puspan. L. 108–173, § 735(c)(1), inserted at end “Members of the Commission shall be treated as employees of Congress for purposes of applying title I of the Ethics in Government Act of 1978 (Public Law 95–521).”
2000—Subsec. (span)(1)(D). Puspan. L. 106–554, § 1(a)(6) [title V, § 544(a)(1)], substituted “June 15 of each year,” for “June 1 of each year (beginning with 1998),”.
Subsec. (span)(7). Puspan. L. 106–554, § 1(a)(6) [title V, § 544(span)], added par. (7).
1999—Subsec. (span)(1)(D). Puspan. L. 106–113 inserted “and including a review of the estimate of the conversion factor submitted under section 1395w–4(d)(1)(E)(ii) of this title” before period at end.
1998—Subsec. (c)(1). Puspan. L. 105–277 substituted “17” for “15”.
Statutory Notes and Related Subsidiaries
Change of NameReferences to Medicare+Choice deemed to refer to Medicare Advantage or MA, subject to an appropriate transition provided by the Secretary of Health and Human Services in the use of those terms, see section 201 of Puspan. L. 108–173, set out as a note under section 1395w–21 of this title.
Effective Date of 2003 AmendmentPuspan. L. 108–173, title VII, § 735(c)(2), Dec. 8, 2003, 117 Stat. 2354, provided that: “The amendment made by paragraph (1) [amending this section] shall take effect on January 1, 2004.”
Effective Date of 2000 AmendmentPuspan. L. 106–554, § 1(a)(6) [title V, § 544(a)(2)], Dec. 21, 2000, 114 Stat. 2763, 2763A–551, provided that: “The amendment made by paragraph (1) [amending this section] shall apply beginning with 2001.”
Effective Date of 1999 AmendmentAmendment by Puspan. L. 106–113 effective in determining conversion factor under section 1395w–4(d) of this title for years beginning with 2001 and not applicable to or affecting any update (or any update adjustment factor) for any year before 2001, see section 1000(a)(6) [title II, § 211(d)] of Puspan. L. 106–113, set out as a note under section 1395w–4 of this title.
Effective Date; Transition; Transfer of FunctionsPuspan. L. 105–33, title IV, § 4022(c), Aug. 5, 1997, 111 Stat. 355, provided that:“(1)In general.—The Comptroller General shall first provide for appointment of members to the Medicare Payment Advisory Commission (in this subsection referred to as ‘MedPAC’) by not later than September 30, 1997.
“(2)Transition.—As quickly as possible after the date a majority of members of MedPAC are first appointed [Oct. 1, 1997, see 62 FR 52131], the Comptroller General, in consultation with the Prospective Payment Assessment Commission (in this subsection referred to as ‘ProPAC’) and the Physician Payment Review Commission (in this subsection referred to as ‘PPRC’), shall provide for the termination of the ProPAC and the PPRC. As of the date of termination of the respective Commissions [Nov. 1, 1997, see 62 FR 59356], the amendments made by paragraphs (1) and (2), respectively, of subsection (span) [amending sections 1395w–4, 1395y, and 1395ww of this title and repealing section 1395w–1 of this title] become effective. The Comptroller General, to the extent feasible, shall provide for the transfer to the MedPAC of assets and staff of the ProPAC and the PPRC, without any loss of benefits or seniority by virtue of such transfers. Fund balances available to the ProPAC or the PPRC for any period shall be available to the MedPAC for such period for like purposes.
“(3)Continuing responsibility for reports.—The MedPAC shall be responsible for the preparation and submission of reports required by law to be submitted (and which have not been submitted by the date of establishment of the MedPAC) by the ProPAC and the PPRC, and, for this purpose, any reference in law to either such Commission is deemed, after the appointment of the MedPAC, to refer to the MedPAC.”
MedPAC Review of Payments to Rural Emergency HospitalsPuspan. L. 116–260, div. CC, title I, § 125(f), Dec. 27, 2020, 134 Stat. 2966, provided that: “Each report submitted by the Medicare Payment Advisory Commission under section 1805(span)(1)(C) of the Social Security Act (42 U.S.C. 1395span–6(span)(1)(C)) (beginning with 2024), shall include a review of payments to rural emergency hospitals under section 1834(x) [42 U.S.C. 1395m(x)], as added by subsection (a).”
Appointment of Experts in Prescription DrugsPuspan. L. 108–173, title VII, § 735(e)(2), Dec. 8, 2003, 117 Stat. 2354, provided that: “The Comptroller General of the United States shall ensure that the membership of the Commission [Medicare Payment Advisory Commission] complies with the amendment made by paragraph (1) [amending this section] with respect to appointments made on or after the date of the enactment of this Act [Dec. 8, 2003].”
MedPAC Analysis of Impact of Volume on Per Unit Cost of Rural Hospitals With Psychiatric UnitsPuspan. L. 106–554, § 1(a)(6) [title II, § 214], Dec. 21, 2000, 114 Stat. 2763, 2763A–486, provided that: “The Medicare Payment Advisory Commission, in its study conducted pursuant to subsection (a) of section 411 of BBRA [Puspan. L. 106–113, § 1000(a)(6) [title IV, § 411], set out as a note below] (113 Stat. 1501A–377), shall include—“(1) in such study an analysis of the impact of volume on the per unit cost of rural hospitals with psychiatric units; and
“(2) in its report under subsection (span) of such section a recommendation on whether special treatment for such hospitals may be warranted.”
MedPAC Study on Complexity of Medicare Program and Levels of Burdens Placed on Providers Through Federal RegulationsPuspan. L. 106–113, div. B, § 1000(a)(6) [title II, § 229(c)], Nov. 29, 1999, 113 Stat. 1536, 1501A–357, required a comprehensive study related to regulatory burdens placed on health care providers and, no later than Dec. 31, 2001, a report and legislative recommendations.
MedPAC ReportPuspan. L. 106–113, div. B, § 1000(a)(6) [title III, § 312(c)], Nov. 29, 1999, 113 Stat. 1536, 1501A–365, provided that: “The Medicare Payment Advisory Commission shall include in its report submitted to Congress in March of 2001 recommendations regarding the appropriateness of the initial residency period used under section 1886(h)(5)(F) of the Social Security Act (42 U.S.C. 1395ww(h)(5)(F)) for other residency training programs in a specialty that require preliminary years of study in another specialty.”
MedPAC Study of Rural ProvidersPuspan. L. 106–113, div. B, § 1000(a)(6) [title IV, § 411], Nov. 29, 1999, 113 Stat. 1536, 1501A–377, required a study evaluating the adequacy and appropriateness of the categories of special payments established for rural hospitals under the medicare program and a report to be submitted no later than 18 months after Nov. 29, 1999.
Quality Improvement StandardsPuspan. L. 106–113, div. B, § 1000(a)(6) [title V, § 520(c)], Nov. 29, 1999, 113 Stat. 1536, 1501A–386, provided that:“(1)Study.—The Medicare Payment Advisory Commission shall conduct a study on the appropriate quality improvement standards that should apply to—“(A) each type of Medicare+Choice plan described in section 1851(a)(2) of the Social Security Act (42 U.S.C. 1395w–21(a)(2)), including each type of Medicare+Choice plan that is a coordinated care plan (as described in subparagraph (A) of such section); and “(B) the original medicare fee-for-service program under parts A and B [sic] title XVIII of such Act (42 U.S.C. 1395 et seq.) [42 U.S.C. 1395c et seq., 1395j et seq.]. “(2)Considerations.—Such study shall specifically examine the effects, costs, and feasibility of requiring entities, physicians, and other health care providers that provide items and services under the original medicare fee-for-service program to comply with quality standards and related reporting requirements that are comparable to the quality standards and related reporting requirements that are applicable to Medicare+Choice organizations.
“(3)Report.—Not later than 2 years after the date of the enactment of this Act [Nov. 29, 1999], such Commission shall submit a report to Congress on the study conducted under this subsection, together with any recommendations for legislation that it determines to be appropriate as a result of such study.”
Initial Terms of Additional MembersPuspan. L. 105–277, div. J, title V, § 5202(span), Oct. 21, 1998, 112 Stat. 2681–917, provided that:“(1)In general.—For purposes of staggering the initial terms of members of the Medicare Payment Advisory Commission (under section 1805(c)(3) of such Act (42 U.S.C. 1395span–6(c)(3))[)], the initial terms of the two additional members of the Commission provided for by the amendment under subsection (a) [amending this section] are as follows:“(A) One member shall be appointed for one year.
“(B) One member shall be appointed for two years.
“(2)Commencement of terms.—Such terms shall begin on May 1, 1999.”
Information Included in Annual RecommendationsPuspan. L. 105–33, title IV, § 4804(c), Aug. 5, 1997, 111 Stat. 552, provided that: “The Medicare Payment Advisory Commission shall include in its annual report under section 1805(span)(1)(B) of the Social Security Act [42 U.S.C. 1395span–6(span)(1)(B)] recommendations on the methodology and level of payments made to PACE providers under sections 1894(d) and 1934(d) of such Act [42 U.S.C. 1395eee(d), 1396u–4(d)] and on the treatment of private, for-profit entities as PACE providers.”
