CMS Alerts Providers About Congressional Inaction on Medicare Physician Payments

 House GOP leaders delayed consideration on December 19 of Senate-passed legislation to extend the payroll tax holiday into the first two months of 2012, and to avert a 27 percent cut in Medicare payments to physicians scheduled to start January 1, 2012. House Speaker John Boehner, R-Ohio, and Majority Leader Eric Cantor, R-Va., said the Senate bill fell short of the full-year extension that the House passed. The House plans to formally reject the Senate-amended version of HR 3630 on December 21 and request a conference with Senate lawmakers to work out differences. Boehner said American businesses and taxpayers need certainty about the tax code for the entire year, not just the first two months. 

Anticipating that Congress might not act in time to stop the physician pay cut, CMS announced on Dec. 19th that has instructed its Medicare claims administration contractors to hold claims for 2012 services paid under the physician fee schedule for the first 10 business days of January – January 1 through January 17. CMS stated that 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 …. after the date of receipt.”

CMS will notify providers and contractors before January 11, 2012 about the status of congressional actions to avert the negative update.

The House-passed version of HR 3630 (discussed in detail in a previous post) provided a 1 percent increase in existing Medicare physician payments for both 2012 and 2013. The Senate-passed version would have delayed the Medicare physician payment cuts only for two months, until February 29, 2012.