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CMS to hold processing claims as congressional stand-off continues

by Brendon Nafziger, DOTmed News Associate Editor | December 22, 2011
As the stand-off in Washington continues over a payroll tax holiday bill that includes a freeze on a looming Medicare reimbursement cut, the Centers for Medicare and Medicaid Services said it would hold off on processing claims for the first 10 business days next year. CMS has done this before during previous down-to-the-wire, legislative dust-ups involving Medicare pay cuts to doctors, in the hopes of giving Congress some extra time to work out a deal.

The 27 percent cut, which is supposed to start January 1, comes from the widely loathed sustainable growth rate formula (SGR). On its website, the American College of Radiology, announcing CMS' processing hold, said the agency believes it won't affect provider cash flow, as under current law it takes at least two weeks to process "clean" electronic claims. Claims submitted before next year are unaffected by the claims hold, of course.

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