CMS Directs Medicare Contractors to Hold Physician Claims Through June 17
By News Staff
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.
What Should I Tell My Patients?
The AAFP has posted an information piece (1-page Word file; About Downloading) about the current Medicare payment crisis that members can share with their patients or post in their waiting rooms. The piece outlines how Medicare rates have remained the same while office costs have increased. Also included is a message to TRICARE patients and information on how patients can take action on the issue, including a link to a letter patients can send to their congressional representatives. The piece can be customized for individual practice settings.
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.
"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.
Related ANN Coverage
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AAFP Encourages Members to Advocate for Long-Term Medicare Payment Fix
Revised Academy Policy Drives Grass-roots Campaign
(6/2/2010)
AAFP Executive Committee Says 'No' to Further Medicare Payment Patches Unless They Meet Academy Criteria
(5/28/2010)
Congress Fails to Avert Medicare Payment Cut Scheduled for June 1
CMS Instructs Contractors to Hold Claims
(5/28/2010)
More From AAFP
Speak Out
Medicare Participation Options for Physicians
Family Practice Management Toolbox
