As the U.S. healthcare industry waits for the Senate to return to vote on a permanent fix to the sustainable growth rate (SGR) formula, the U.S. Centers for Medicare and Medicaid Services (CMS) has issued guidance on how it will handle claims until the fix is implemented.
A 21% cut in payments under the Medicare Physician Fee Schedule went into effect on April 1 due to the inability of Congress to pass legislation before it adjourned for spring recess. But CMS said it will try to ameliorate the impact of the cut on Medicare providers and beneficiaries starting April 1 by holding claims for a short period of time.
This will allow CMS to implement any subsequent Congressional action while minimizing the reprocessing of claims and any associated disruption of cash flow to physicians once pending legislation addressing the 21% cut is passed.
Other provisions that are expiring on April 1 include exceptions to caps for outpatient therapy, add-on payments for ambulance services, payments for low-volume hospitals, and payments for Medicare-dependent hospitals.
CMS said it will provide information about the next steps it is taking with respect to the SGR on April 11.
