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CMS instructs carriers to hold claims for 10 business days to avoid 21% payment cut
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The Centers for Medicare and Medicaid Services has asked its carriers to hold physician claims for 10 business days, or 14 calendar days, to give Congress time to alter the physician payment formula or delay a 21% payment cut that took effect April 1.
On March 2, the U.S. Senate passed a bill that extended unemployment benefits and delayed the physician payment cut until April 1. The House approved the measure on Feb. 25.
The payment cut stems from the sustainable growth rate (SGR), a key factor in annual Medicare physician payment updates. Congress has passed several temporary “fixes” to stall payment cuts in recent months.
The U.S. Senate is expected to vote April 12 on a separate bill that would delay the payment cut until May 1.
The American Medical Association (AMA) sent the following response to a query from Samuel M. Silver, MD, PhD, professor in the department of internal medicine and director of the University Cancer Center Network at the University of Michigan Cancer Center:
“In a reply to the standoff that occurred a month ago, this time it was Senator Tom Coburn of Oklahoma who objected to the bill’s consideration, on the basis that it should not be considered emergency spending that would be exempt from budgetary offsets. As a result, Congress will adjourn for its 2-week spring recess without taking action to stop these programs from expiring. We are told that the Senate plans to hold a cloture vote after the recess which, if supported by 60 Senators, will allow a vote to occur on the legislation and that could occur as early as April 12.”
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