CMS contingency plan on SGR will delay reimbursement cut

 - Reimbursement Cuts

The Centers for Medicare and Medicaid Services (CMS) is putting into effect a contingency plan to avoid a 21% cut to Medicare physician reimbursements scheduled to go into effect Wednesday, April 1.

The action has become necessary after the Senate went into recess without voting on a bill passed by the House that repeals the sustainable growth rate (SGR).

CMS has announced that it will hold electronic claims for the first 14 calendar days of April, and paper claims for the 29 days after the date of receipt. This delay in claim processing will allow CMS to pay for services at the normal rate if and when Congress retroactively repeals the cuts in any legislation that is finally passed.

Last week the House passed a bill by a vote of 392-37 that would permanently repeal the sustainable growth rate formula for Medicare physician reimbursement. Despite pressure from the House and President Obama, the Senate went into a two-week recess without addressing the legislation.

The American Medical Association criticized the Senate’s failure to take up the bill, and AMA President Robert Wah, MD, urged senators to “immediately address this issue upon their return and once-and-for-all lay this destructive issued to rest by building the stable and sustainable Medicare program that our nation’s patients and physicians need and deserve.”

Congress reconvenes Monday, April 13, and according to news reports, Senate Majority Leader Mitch McConnell (R-Ky.) plans on making the SGR repeal legislation its first order of business.