The Centers for Medicare and Medicaid Services (CMS) Placed 10 day Hold on All Medicare Claims

On July 2^nd all Medicare Contractors were instructed to hold all Medicare claims for services dates July 1, 2008 or later, for 10 business days. This hold was placed to allow Congress more time to consider legislation related to the Medicare payment cuts that were scheduled to take effect July 1, 2008.

In December 2007 Congress had passed a law to postpone the cuts scheduled for January 1, 2008 for six months which went thru June 30, 2008. The new law contained a formula which reflected an increase of about 0.5 percent from the 2007 reimbursement rates.

This new halt will only last until July 15^th. If Congress fails to come up with a new law before July 15^th health care providers will see about a 10.6 percent cut from the 2007 rates.

There is a law pending called The Medicare Improvements for Patients and Providers Act which would postpone the steep payment cuts for an additional 18 months. This Act includes a 1.1 percent increase for 2009. However the law hasn’t made it out of the House of Representatives yet.

In the meantime there is nothing that we providers/billers can do but sit and wait to see what Congress ends up doing. It is such a huge cut that it greatly affects all health care providers. Rumors are that up to 60 percent of Participating Medicare Providers plan on dropping out of the program if the cuts are put into place.

It is understandable why they would want to drop out. However the problem is that by dropping out they are really only hurting the Medicare patients and the providers who stay in the program. There is no good outcome if the cuts are put into place.

Hopefully Congress will do the right thing for Medicare and come up with an alternative to the 10.6 percent cut in reimbursement rates.