PSA Alert: Medicare Physician Fee Schedule
CMS announced late yesterday that it has instructed its contractors to hold claims containing services paid under the Medicare Physician Fee Schedule (MPFS) for the first 10 business days in June (effectively, through June 14), in order to allow more time for Congress to pass legislation that will avert the 21% negative update currently scheduled to rake effect on June 1. This temporary hold will only affect claims with dates of service on or after June 1, and should have minimal impact on provider cash flow since Medicare does not pay any claims sooner than 14 calendar days after receipt anyway.
The House of Representatives is planning to take up debate today on the American Jobs and Closing Tax Loopholes Act (HR 4213), which includes a provision advocated by the American Medical Association which would increase the MPFS payment rates by 1.3% for the remainder of 2010 and 1.0 % in 2011 and provides that rates could not be reduced in 2012 or 2013. Under this proposal, if a permanent "SGR fix" is not enacted before 2014, the current SGR would kick back in at that time with an estimated 35% reduction in the MPFS.
The House remains very divided on the issue and even if they do wind up passing the bill, it must go to the Senate where it may face even stiffer opposition. In any event, it appears unlikely at this point that the measure will be passed before Congress adjourns this afternoon for its Memorial Day recess, which has prompted the decision by CMS to once again delay processing of claims. Congress is scheduled to return from its break on Tuesday, June 8.
John R. Outlaw, CHC, CHBME
Chief Compliance Officer
PSA, LLC - A MED3OOO Company
Phone: 843-629-2945 | Fax: 843-629-2961
www.psapath.com | www.med3000.com