CMS to mitigate 21 percent payment reduction for Medicare providers

As of April 1, provider reimbursement for treating Medicare patients decreased 21 percent under current law for the Medicare Physician Fee Schedule. However, CMS is holding claims submitted for services rendered on and after that date to minimize claims reprocessing and disruption of provider cash flow in the event of legislation addressing the payment reduction. As stated in its recent email  to providers, CMS will provide more information about next steps by April 11, 2015. COA will keep members apprised.

By way of background, the US House of Representatives sent a bill to the US Senate, which President Obama has promised to sign, abolishing the sustainable growth rate (SGR) formula that has threatened doctors of optometry and other health care providers’ Medicare reimbursements for years. However, because the US Senate had not acted on the measure before April 1, the SGR triggered a 21 percent decrease in reimbursements effective on that date. It is widely hoped and expected the Senate will pass the bill upon its return from recess on April 13. Again, COA and AOA will keep members informed as developments unfold.

For more details on the Medicare reimbursement decrease, click here >>