As it has before, the CMS is preparing to instruct its claims administration contractors to hold claims under the Medicare physician fee schedule because of a steep payment cut to physicians that is scheduled for Jan. 1.
CMS tells claims contractors to delay processing because of looming payment cut
In a notice Monday, the CMS said it will guide contractors to hold claims containing 2012 services paid under the Medicare physician fee schedule from Jan. 1 until Jan. 17. Any services that were provided on or before Dec. 31 would be unaffected and processed under normal timeframes.
“The administration is disappointed that Congress has failed to pass a solution to eliminate the sustainable growth rate (SGR) formula-driven cuts, and has put payments for healthcare for Medicare beneficiaries at risk,” the notice said. “We continue to urge Congress to take action to ensure these cuts do not take effect.”
This past weekend, the Senate passed an amended version of a payroll tax cut bill that the House approved last week, and both measures would avert a 27.4% reduction in Medicare physician payments that is scheduled for Jan. 1. The House legislation includes a two-year patch to the SGR formula and would provide a 1% payment increase to the nation's doctors in 2011 and 2012. But that differs greatly from the Senate-passed version, which would freeze Medicare physician payments until Feb. 29. The House is expected to vote on the Senate bill on Monday evening.
The CMS will notify contractors on or before Jan. 11 about the status of any congressional action to avert the payment reduction and what that would mean for the claims hold.
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