CMS Pauses Claim Payments Until Congress Passes Sequester Fix

The House is on recess but expected to pass the bill when it returns to Washington, D.C., on April 13.

A version of this article was first published April 5, 2021, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.

CMS is holding payments for claims submitted on or after April 1 in anticipation of legislation that will extend the suspension of a 2% cut (sequester) to all Medicare payments, according to a special edition of MLN Connects.

The Senate recently passed a bill that would eliminate the 2% sequestration of Medicare reimbursements through the end of 2021.

The House is on recess but expected to pass the bill when it returns to Washington, D.C., on April 13.

According to CMS, temporarily withholding payments will “minimize the volume of claims the MACs [Medicare Administrative Contractors] must reprocess if Congress extends the suspension.”

MACs will reprocess any claims paid with the reduction applied, if necessary.

Extension of the sequester is a major priority for the American Medical Association, American Hospital Association, and other physician groups who believe the 2% payment cut would financially devastate already distressed physician practices.