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Medicare to hold claims till Friday

by Brendon Nafziger, DOTmed News Associate Editor | June 14, 2010
Medicare cuts delayed.
As the Senate decides whether to pass legislation averting a looming 21 percent Medicare pay cut to physicians, the Centers for Medicare and Medicaid Service told its contractors to hold claims until the end of the week, DOTmed News has learned.

By delaying the processing until June 18, CMS hopes Congress will pass the so-called "doc fix" before pay cuts, scheduled to start today, take effect.

"This action will facilitate accurate claims processing at the outset and minimize the need for claims reprocessing if congressional action changes the negative update," the CMS wrote in an email obtained by DOTmed. "It also should minimize the provider and beneficiary burdens and costs associated with reprocessing claims."
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The Medicare cut to doctors was initially set to take effect June 1, but CMS told contractors to delay processing payments for 10 business days to give the Senate a chance to pass legislation the House cleared last month.

The bill, a segment of a wider benefits package, H.R. 4213, postpones the cuts, derived by the sustainable growth rate, until December 2011, while boosting payment rates 2.2 percent in June and another 1 percent in January.

The Senate is expected to take up the issue Monday.

The American Medical Association blasted Congress Sunday as it launched the "Write Coat Rally," where physicians mailed to Washington signed lab coats in protest of delays in overturning the cuts.

"The Senate's failure to act before June 1 made the 21 percent cut the law of the land, and this week Medicare's temporary hold on claims expires," AMA President AMA President Dr. J. James Rohack said in a statement.

"Congress created this problem; now they need to fix it."

But the CMS is confident the Senate will pass the legislation.

"We understand that the delayed processing of Medicare claims may present cash flow problems for some Medicare providers," CMS said in the email. "However, we expect that the delay, if any, beyond the normal processing period will be only a few days."