The Senate Punts on SGR Fix Until After Spring Recess; CMS holds claims through April 14, 2015

Following the overwhelming passage of the permanent Medicare physician payment overhaul in the House, the Senate leadership has decided they will work to vote on a similar measure but not until after a two week recess. The 21% Medicare physician payment cuts will go into effect on April 1, 2015. However, the Centers for Medicare and Medicaid Services (CMS) has announced that it will hold claims through April 14, 2015, in anticipation of the Senate acting quickly upon its return to remedy the cuts retroactively. Please reach out to your local Medicare Administrative Carrier for specific questions regarding claims.

In the meantime, ASNC suggests continued outreach to senators requesting passage of the Medicare Access and CHIP Reauthorization Act (MACRA), which passed the House on March 26, 2015, with a decisive vote of 392 to 37. This legislation H.R. 2, which is supported by ASNC, would permanently repeal the SGR. If the Senate does not pass H.R. 2, cuts would either take effect or Congress would need to pass another temporary patch. Read ASNC Letter of HR Support. 

Under MACRA, Part B provider payments would be updated by 0.5 percent July 1, 2015 through 2019. Professionals who remain in fee-for-service Medicare would do so in exchange for zero updates in 2019-2025, while providing professionals with the opportunity to receive additional payment adjustments though a new quality incentive payment program. In 2026 and subsequent years, professionals participating in advanced payment models that meet certain criteria would receive annual updates of .75 percent, while all other professionals would receive annual updates of 0.25 percent. The bill would also extend funding for the Children's Health Insurance Program (CHIP) through fiscal year 2017, which ends on Sept. 30, 2015.