Medicare continues doc payments despite SGR-required cut - NephrologyNews.com PDF Print

Medicare physicians will still get their regular paycheck this week despite a law that was supposed to trigger a 21% cut in wages on April 1.

“CMS is taking steps to limit the impact on Medicare providers and beneficiaries by holding claims for a short period of time beginning on April 1,” The Centers for Medicare & Medicaid Services said in a statement. “Holding claims for a short period of time allows CMS to implement any subsequent Congressional action while minimizing claims reprocessing and disruption of physician cash flow in the event of legislation addressing the 21% payment reduction.”

Under current law, electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt.


Related:

Congress revives efforts to fix doc payment formula


Congress has been working on a replacement for the outdated sustainable growth rate formula for several months, pushing past the April 1 deadline with a final bill for President Barack Obama to sign. The bill permanently fixes Medicare reimbursement for doctors and includes a two-year extension for a popular children's health insurance program and money for community health centers.

The House passed the bill with a 392-37 vote, and it awaits a Senate review.

In addition to the Medicare Physician Fee Schedule adjustment, other provisions affecting providers were set to expire April 1, including exceptions to the outpatient therapy caps, add-on payments for ambulance services, payments for low volume hospitals, and payments for Medicare dependent hospitals.

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