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Congress Passes Two-Month Retroactive SGR Patch
On the evening of April 15, both the U.S. Senate and House of Representatives passed H.R. 4851, legislation containing a two-month fix to the 21% Medicare physician payment cuts that went into effect on April 1, 2010, effective retroactive to and including April 1, 2010. The President immediately signed the legislation into law late that evening. This sustainable growth rate (SGR) freeze will stave off the 21% physician payment cuts until June 1, 2010.
The Centers for Medicare & Medicaid Services (CMS) held claims through Wednesday, April 14, 2010. Some carriers began processing claims at the reduced payment rate on April 15, on a rolling basis with the earliest dates of service processed first. Current law prohibits CMS from processing claims any earlier than 14 days after receipt, so only April 1 claims submitted to and received by CMS on April 1 should be impacted by the temporarily lower rates that have now been reversed.
The freeze is currently in effect and CMS is expected to begin processing claims at the restored payment level today, including all claims received on or after April 2. It is expected that CMS will soon instruct the carriers to send payments making up the balance for any April 1 claims paid at the reduced rate. It is not expected that CMS will require any claims to be resubmitted.
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