December 21, 2011
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CMS advises providers to hold 2012 Medicare claims for first 10 days of January

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The CMS is directing providers and claims administration contractors to delay filing claims for services paid under the 2012 Medicare Physician Fee Schedule, the agency announced in a news release.

Providers are advised to hold 2012 claims for the first 10 business days of January. The directive is intended to help providers avoid a 27.4% Medicare physician payment cut scheduled to take effect Jan. 1.

The hold is expected to have a minimal impact on providers’ cash flow because, under the current law, clean electronic claims are paid no sooner than 14 calendar days after the date of receipt and paper claims are paid no sooner than 29 days after the date of receipt.

Medicare physician claims for services provided on or before Dec. 31 are unaffected by the claims hold and will be processed and paid under normal procedures and schedules.

“The [Obama] Administration is disappointed that Congress has failed to pass a solution to eliminate the sustainable growth rate formula-driven cuts, and has put payments for health care for Medicare beneficiaries at risk,” the release said. “We continue to urge Congress to take action to ensure these cuts do not take effect.”

The US House of Representatives voted this week to reject a Senate bill that would delay the physician payment cut and extend the payroll tax cut for 2 months. An original House version of the bill, passed Dec. 13, called for a 2-year delay of the Medicare payment cut and extension of the payroll tax cut.

CMS will provide more information on congressional action and steps concerning the claims hold on or before Jan. 11, the release said.

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