April 1, 2021

As many of our readers may remember, the mandatory sequestration payment reduction of two percent, to be applied to all Medicare Fee-For-Service (FFS) claims, was put on hold by the Coronavirus Aid, Relief, and Economic Security (CARES) Act.  The suspension of these payment cuts ran from May 1 through December 31, 2020.  Then, the Consolidated Appropriations Act (CAA), signed into law on December 27, extended the suspension of sequestration through March 31, 2021.  That means that today, April 1, the two-percent cut in Medicare payments are scheduled to go into effect.  However, help may be on the way.

New Legislative Activity

In a bipartisan effort, the United States Senate passed a bill last week that would extend the suspension of the two-percent Medicare cuts through the end of the public health emergency (PHE).  The U.S. House of Representatives had passed similar legislation the previous week that would extend the pause in sequestration to the end of this calendar year.  The House is expected to take up the Senate’s version of the bill after it returns from break on April 12.

Latest CMS Action

In anticipation of possible congressional action to extend the suspension of the two-percent sequester reduction, the Centers for Medicare and Medicaid Services (CMS) has instructed its Medicare Administrative Contractors (MACs) to hold all claims with dates of service on or after April 1, 2021, in order to minimize the volume of claims the MACs must reprocess should Congress extend the suspension.  With swift action from Congress, it is hoped that this delay in processing will not impact provider cash flow, and we can look forward to nine months without the two percent reduction to Medicare revenue.

We will update you on this issue as pertinent facts become available.  In the meantime, you can reach us at info@anesthesiallc.com.