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CMS prepares to make 21% Medicare rate cut should Congress fail to act before April 1



With an April 1 deadline looming, Congress has a week left to stop the 21 percent sustainable growth rate (SGR) cuts to the Medicare reimbursement rate. While Congress works to pass bills H.R. 2 and S. 810 to permanently end the SGR and implement new Medicare funding models, the Centers for Medicare and Medicaid Services (CMS) has announced that without Congressional action, the 2015 Medicare Physician Fee Schedule is scheduled to take effect on April 1, 2015.

House Speaker John Boehner (R-OH) and Minority Leader Nancy Pelosi (D-CA) have negotiated a bipartisan agreement to fund the Medicare SGR payment reform legislation. They intend to hold a vote on the House floor as early as this week. House Majority Leader Kevin McCarthy (R-CA) said that “Congress has never been closer.”

CMS announced that Medicare claims for services rendered on or before March 31, 2015, are unaffected by the payment cut and will be processed and paid under normal procedures and time frames.

According to CMS, under current law, electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt. CMS will notify providers on or before April 11, 2015, with more information about the status of Congressional action to avert the negative update and next steps.

Contact: Michele Kelly, (213) 226-0338 or mkelly@cmanet.org.



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