CMS Directs Medicare Contractors to Hold Physician Claims Through June 17

CMS has notified its Medicare contractors that they should continue to hold physician claims for services provided to Medicare beneficiaries through June 17 as Congress continues to work on a solution to the 21.3 percent cut in the Medicare payment rate that took effect June 1.

CMS had instructed its contractors to hold Medicare claims for the first 10 business days of June to give Congress more time to pass a payment patch to negating the pay cut called for under the sustainable growth rate formula used to set the Medicare payment rate. Now, the agency has extended the hold through June 17. The order affects Medicare claims dated June 1 and beyond.

In correspondence to contractors and other stakeholders, CMS said that it anticipates congressional action soon that will avert the 21.3 percent pay cut. "CMS is hopeful that congressional action will be taken within the next several days to avert the negative update," said the e-mail message.

"This action will facilitate accurate claims processing at the outset and minimize the need for claims reprocessing if congressional action changes the negative update," said CMS. "It also should minimize the provider and beneficiary burdens and costs associated with reprocessing claims."

The hold on claims will lift on June 18.

CMS acknowledged that the delayed processing of Medicare claims "may present cash flow problems for some Medicare providers," but the agency said it expects that any delays in payment will be short-lived.