About the Medicare Payment Advisory Commission (MedPAC)

The Medicare Payment Advisory Commission (MedPAC) is an independent federal body established by the Balanced Budget Act of 1997 to advise the U.S. Congress on issues affecting the Medicare program. With a broad mandate, everything from advising the Congress on payments to private health plans participating in Medicare and providers in Medicare's traditional fee-for-service program to analyzing access to care, quality of care, and other issues affecting Medicare, MedPAC has the ability to make sweeping changes to the Medicare system. Due to the influence of the commission and the 17 commissioners, NRHA closely monitors MedPAC and nominates strong rural candidates for the commission.

Rural representation

Federal law requires that MedPAC representation include "a balance between urban and rural representatives." Unfortunately, only two of the current 17 commissioners have solid rural credentials (George Miller, appointed in the Spring 2008, joins Tom Dean, appointed in 2007). Clearly this is not balance.

The NRHA has worked with the Government Accountability Office to identify rural candidates for MedPAC and has attempted to explain why rural representation is so vital to rural Medicare beneficiaries (over 27 percent of the Medicare population). We are now working with congressional champions to mandate that the number of rural MedPAC Commissioners be proportional to the population of rural Medicare beneficiaries. Please tell your member of Congress to support these efforts:

S. 498 - Rural Medicare Equity Act (Senators Feingold and Collins)
H.R. 1730- MedPAC Rural Representation Act (Reps. Walden and Pomeroy)

Nomination Letters

The Government Accountability Office holds each of these nominations permanently to use as reference during their next opening. For more information about any of these nominees or to learn more information about MedPAC, contact our Government Affairs Office at 202-639-0550 or dc@NRHArural.org.