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Upper Payment Limits for Hospitals: Proposed Recommendations to Improve Compliance

Following up on the Commission’s discussion at the September 2018 public meeting, this presentation reviews a package of two proposed recommendations related to upper payment limit (UPL) payments to hospitals. The proposed recommendations include:

  • certifying that UPL data are accurate and complete; and,
  • making UPL data publicly available.

The presentation concludes by discussing next steps for MACPAC’s work on UPL payments, including potential future work exploring changes to the methods that states can use to calculate the UPL.

The Commission is expected to vote on these recommendations at its January 2019 meeting.