CMS Issues Guidance on Physician Claims Submission Regarding Planned Physician Payment Cuts
Congress has passed legislation to avert a planned 10.6 percent cut in physician payments which became effective July 1. The Centers for Medicare and Medicaid Services announced that it will work with Congress, health care providers and the beneficiary community to avoid any disruption in the delivery and payment of physician and non-physician practitioner services.
In this regard, the agency has instructed its contractors to not process any physician and non-physician practitioner claims for the first 10 business days of July.
Under current law, electronic claims are not to be paid any sooner than 14 days (29 days for paper claims) and not later than the 30th day they are submitted (otherwise, CMS must pay interest on those claims).
By holding claims for health care services that are delivered on or after July 1, CMS will not be making any payments on the 10.6 percent reduction until July 15, at the earliest. Meanwhile, all claims for services delivered on or before June 30 will be processed and paid in regular order.
In addition to the temporary hold on July claims, CMS is considering additional actions the agency can take to address other expiring Medicare and Medicaid provisions. The agency has indicated that it may provide a complete list of those actions as early as June 30.
The College will continue to keep you informed regarding any additional action CMS might take with regard to physician claims or other July 1 expirations.
