PPM Pages December 2011

As of this afternoon, the House and Senate have been unable to agree on a fix to the SGR cut scheduled to take effect on January 1, 2012. Each respective body has enacted legislation postponing the cut but they disagree on the length of the postponement, as well as how to pay for the short-term fix.

In light of the ongoing disagreement, the Centers for Medicare and Medicaid Services (CMS) has released the following announcement:

The negative update under current law for the 2012 Medicare Physician Fee Schedule is scheduled to take effect on Sunday, Jan. 1, 2012, eight business days from today. Consequently, as on numerous occasions in the past, CMS will instruct its Medicare claims administration contractors to hold claims containing 2012 services paid under the Medicare Physician Fee Schedule for the first 10 business days of January 2012 (i.e., Sunday, Jan. 1 through Tuesday, Jan. 17). The hold should have minimal impact on provider cash flow because, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt. 

Medicare Physician Fee Schedule claims for services rendered on or before Saturday, Dec. 31 are unaffected by the 2012 claims hold and will be processed and paid under normal procedures and time frames.

CMS will notify you on or before Wednesday, Jan 11, 2012, with more information about the status of Congressional action to avert the negative update and next steps regarding the claims hold.

Precision remains hopeful that Congress and the President will act to avert the scheduled Medicare payment cut and will continue to keep you updated on this topic.