No legislative wrangling can take place until April 12.
Unless Congress steps in soon, you could be facing the 21.2 percent Medicare pay cut that you’ve feared since January.
Despite several Congressional attempts to cobble together another temporary pay fix to prevent cuts to your Medicare pay, no votes solidified these efforts. Lawmakers went on recess on March 29, leaving practices to face the 21.2 percent pay cut effective April 1.
Claims hold: Congress returns on April 12, and your MACs will wait until after that before they begin processing claims, in hopes that lawmakers will pass another extension to the pay freeze.
“CMS believes Congress is working to avert the negative update that will take effect April 1,” CMS noted in a March 26 email to providers. “Consequently, CMS has instructed its contractors to hold claims containing services paid under the MPFS … for the first 10 business days of April. This hold will only affect claims with dates of service April 1, 2010, and forward.”
Should you hold your claims? “If you can track submitted claims, then just keep sending them in. You can create a report from which you can resubmit or submit for an increase if they get paid on the old schedule that is updated,” advises Quinten A. Buechner, MS, MDiv, CPC, ACSFP/ GI/PEDS, PCS, CCP, CMSCS, president of ProActive Consultants in Cumberland, Wis.
If you can’t track the claims or easily find out which ones your MAC paid, then you might consider holding them. “This will prevent claims from getting lost in the system,” Buechner says. “The drawback is your claims will get in line after all the other claims already in-house at the carrier, so payment may be slower.”
Industry reaction: Physician groups, which have grown tired of the monthly extensions, expressed displeasure at the passing of the April 1 deadline.
“One month ago when Congress delayed this year’s 21 percent cut to April 1, we urged them to use this time wisely to repeal the payment formula that projects these cuts,” noted AMA president J. James Rohack, MD, in a March 26 statement. “It is unconscionable for elec-ted officials to play politics with se-niors and military families who rely on them to preserve their ability to see the physician of their choice.”
@ Part B Insider, Editor-in-Chief: Torrey Kim, CPC
Want to know more? Attend the 2010 Physician Fee Schedule: Rate Reductions, Imaging Accreditation, Stark Clarification and More (or order the transcript/CDs).
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