This presentation reviews two draft recommendations related to upper payment limit (UPL) payments to hospitals. Based on areas of consensus the Commission reached at the December 2018 MACPAC meeting, the proposed recommendations, approved unanimously, direct the Secretary of the Department of Health and Human Services (HHS) to:
- establish process controls to ensure that UPL demonstration data are accurate and complete, and that HHS uses them to review claimed expenditures, and
- make hospital-specific UPL data available to the public in a standard format that permits analysis.
The downloadable slide presentation reflects the text of the recommendation as discussed at this session.