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In this week’s FutureFocus, is a letter from the Medicare Payment Advisory Commission (MedPAC) to CMS Administrator, Seema Verma. The letter is commenting on the Centers for Medicare & Medicaid Services’ (CMS) proposed rule entitled “Medicare and Medicaid Programs; CY2019 home health prospective payment system rate update and 2020 case-mix adjustment methodology refinements; home health value-based purchasing model; home health quality reporting requirements; home infusion therapy requirements; and training requirements for surveyors of national accrediting organizations,” Federal Register, vol. 83, no. 134, p. 32340 (July 12, 2018). We provide the in-depth comments. This is a must read for all providers. Will MedPAC's comments influence the final rule?