Source
(Aug. 14, 1935, ch. 531, title XVIII, § 1805, as added Pub. L. 105–33, title IV, § 4022(a), Aug. 5, 1997, 111 Stat. 350; amended Pub. L. 105–277, div. J, title V, § 5202(a), Oct. 21, 1998, 112 Stat. 2681–917; Pub. L. 106–113, div. B, § 1000(a)(6) [title II, § 211(a)(2)(B)], Nov. 29, 1999, 113 Stat. 1536, 1501A–347; Pub. L. 106–554, § 1(a)(6) [title V, § 544(a)(1), (b)], Dec. 21, 2000, 114 Stat. 2763, 2763A–551; Pub. L. 108–173, title VII, § 735(a)–(c)(1), (e)(1), Dec. 8, 2003, 117 Stat. 2353, 2354; Pub. L. 110–173, title III, § 301, Dec. 29, 2007, 121 Stat. 2514.)
References in Text
Parts A, B, and C of this subchapter, referred to in subsec. (b)(2)(A), (B), are classified to sections
1395c et seq., 1395j et seq., and 1395w–21 et seq., respectively, of this title.
The Ethics in Government Act of 1978, referred to in subsec. (c)(2)(D), is
Pub. L. 95–521, Oct. 26, 1978,
92 Stat. 1824, as amended. Title I of the Act is set out in the Appendix to Title 5, Government Organization and Employees. For complete classification of this Act to the Code, see Short Title note set out under section 101 of
Pub. L. 95–521 in the Appendix to Title 5 and Tables.
The provisions of title 5 governing appointments in the competitive service, referred to in subsec. (d)(1), are classified generally to section
3301 et seq. of Title 5, Government Organization and Employees.
Amendments
2007—Subsec. (a).
Pub. L. 110–173 inserted “as an agency of Congress” after “established”.
2003—Subsec. (b)(2)(B)(i).
Pub. L. 108–173, § 735(b), inserted “the efficient provision of” after “expenditures for”.
Subsec. (b)(8).
Pub. L. 108–173, § 735(a), added par. (8).
Subsec. (c)(2)(B).
Pub. 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).
Pub. 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. (b)(1)(D).
Pub. 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. (b)(7).
Pub. L. 106–554, § 1(a)(6) [title V, § 544(b)], added par. (7).
1999—Subsec. (b)(1)(D).
Pub. 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).
Pub. L. 105–277 substituted “17” for “15”.
Change of Name
References 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
Pub. L. 108–173, set out as a note under section
1395w–21 of this title.
Effective Date of 2003 Amendment
Pub. 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 Amendment
Pub. 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 Amendment
Amendment by
Pub. 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
Pub. L. 106–113, set out as a note under section
1395w–4 of this title.
Effective Date; Transition; Transfer of Functions
Section 4022(c) of
Pub. L. 105–33 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 (b) [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.”
Appointment of Experts in Prescription Drugs
Pub. 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 Units
Pub. 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 [
Pub. 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 (b) 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 Regulations
Pub. L. 106–113, div. B, § 1000(a)(6) [title II, § 229(c)], Nov. 29, 1999,
113 Stat. 1536, 1501A–357, provided that:
“(1) Study.—The Medicare Payment Advisory Commission shall undertake a comprehensive study to review the regulatory burdens placed on all classes of health care providers under parts A and B of the medicare program under title XVIII of the Social Security Act [this subchapter] and to determine the costs these burdens impose on the nation’s health care system. The study shall also examine the complexity of the current regulatory system and its impact on providers.
“(2) Report.—Not later than December 31, 2001, the Commission shall submit to Congress one or more reports on the study conducted under paragraph (1). The report shall include recommendations regarding—
“(A) how the Health Care Financing Administration can reduce the regulatory burdens placed on patients and providers; and
“(B) legislation that may be appropriate to reduce the complexity of the medicare program, including improvement of the rules regarding billing, compliance, and fraud and abuse.”
MedPAC Report
Pub. 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 Providers
Pub. L. 106–113, div. B, § 1000(a)(6) [title IV, § 411], Nov. 29, 1999,
113 Stat. 1536, 1501A–377, provided that:
“(a) Study.—The Medicare Payment Advisory Commission shall conduct a study of rural providers furnishing items and services for which payment is made under title XVIII of the Social Security Act [this subchapter]. Such study shall examine and evaluate the adequacy and appropriateness of the categories of special payments (and payment methodologies) established for rural hospitals under the medicare program, and the impact of such categories on beneficiary access and quality of health care services.
“(b) Report.—Not later than 18 months after the date of the enactment of this Act [Nov. 29, 1999], the Medicare Payment Advisory Commission shall submit to Congress a report on the study conducted under subsection (a).”
Quality Improvement Standards
Pub. 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.) [parts A and B of this subchapter].
“(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 Members
Pub. L. 105–277, div. J, title V, § 5202(b), 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.
1395b–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 Recommendations
Section 4804(c) of
Pub. L. 105–33 provided that: “The Medicare Payment Advisory Commission shall include in its annual report under section 1805(b)(1)(B) of the Social Security Act [subsec. (b)(1)(B) of this section] recommendations on the methodology and level of payments made to PACE providers under sections 1894(d) and 1934(d) of such Act [sections
1395eee
(d) and
1396u–4
(d) of this title] and on the treatment of private, for-profit entities as PACE providers.”