Photo - RBS Employee

Radiation Business Solutions Blog

What the SGR Vote Delay Means for Your Practice

Dan Moore - Friday, March 27, 2015

Although the House passed the “doc fix” bill, the Senate delayed a vote until after their 2-week recess. The plan that the House approved will cap the pay increase at 0.5% annually for the next four years, followed by six years of flat payment rates. Another facet of the bill is that it will push towards more value-based payment programs.

Since the Senate has not yet voted on the plan, CMS will not enact the 21% cut to the Medicare fee schedule that was slated for April 1. Instead CMS will hold Medicare payments beginning April 1 until the bill has been voted on when Senate reconvenes on April 13. This will not affect dates of service prior to April 1, but Medicare payments for dates of service within the first few weeks of April may be delayed until late April or early May.

The following notice was sent from the CMS earlier this week:

Attention Health Professionals: Information Regarding the 2015 Medicare Physician Fee Schedule

The negative update of 21% under current law for the Medicare Physician Fee Schedule is scheduled to take effect on April 1, 2015. Medicare Physician Fee Schedule claims for services rendered on or before March 31, 2015, are unaffected by the payment cut and will be processed and paid under normal procedures and time frames. The Administration urges Congress to take action to ensure these cuts do not take effect. However, until that happens, CMS must take steps to implement the negative update. Under current law, electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt. CMS will notify you on or before April 11, 2015, with more information about the status of Congressional action to avert the negative update and next steps.

RBS will continue to submit claims regularly to ensure payments are processed as soon as the hold is lifted. We will also continue to provide updates as this develops.