MedPAC May Stop Covering “Low Value” Procedures

The Medicare Payment Advisory Commission (MedPAC) is considering a plan that would stop covering “low value” procedures and tests due to their return on investment being too low. The procedures cost Medicare nearly $6 billion a year but yield little benefit, according to panel members. MedPAC came to this decision after exploring the results of 2012 analysis that found $5.8 billion in claims were paid that year for “low value procedures,” including a computed tomography for lung cancer and a prostate-specific antigen test for prostate cancer. As an alternative, MedPAC might consider charging beneficiaries more for low value services. MedPAC leaders say the cost of these procedures “subtract from the availability of public resources for high-value services and ‘appropriate subsidies’ for low-income people.”

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