CMS: Questions and Answers on Announced 10 Day Hold
Centers for Medicare & Medicaid Services (CMS) officials
have instructed Medicare contractors
not to process any physician Medicare claims for
the first 10 business days of July
because Congress failed to block the cut in payments to
The 2008 Medicare Fee Schedule by Geographic Region
We are still hoping that Congress will act quickly and fix the
Medicare fee schedule retroactively, but for those of you who need
to know, below are the
that implement the 10.6 percent cut effective July 1,
"By holding claims for health care services that are delivered
on or after July 1, CMS will not be making any payments on the
10.6-percent reduction until July 15, at the earliest," Elizabeth
Hall, director of the CMS Office of Legislation, said in an e-mail
to several Senate and House of Representatives committees.
"Meanwhile, all claims for services delivered on or before June 30
will be processed and paid in regular order."
Ms. Hall says CMS wants to work with Congress, physicians, and
Medicare patients "to avoid any disruption in the delivery and
payment of physician and nonphysician practitioner services
beginning on July 1."
Health and Human Services (HHS) Secretary Mike Leavitt said HHS
"will take all steps available to the department under the law to
minimize the impact on providers and beneficiaries." He did not say
what those steps might be.
"We urge Congress to move quickly when it returns from the 4th
of July recess to pass a bipartisan bill that the president can
sign. ... The bill should also extend the Transitional Medical
Assistance program to help families transition from welfare to work
and the Qualified Individual program, which provides important
services to low-income beneficiaries," he said.
Secretary Leavitt said the Bush administration "is committed to
working with Congress to secure passage of legislation that can be
signed into law by the president. Once enacted, we will move
promptly to reprocess claims and take other steps necessary to
ensure that providers and beneficiaries are not negatively
The American Medical Association issued a statement urging
Congress to pass legislation to stop the cuts early in the week of
July 7. However, it said, there is no guarantee that Congress will
solve the problem immediately.
"Although the constant stream of e-mails from Medicare carriers
to their physician listservs can be impossible to keep up with,
it's a good idea over the next few weeks to pay especially close
attention to any messages physicians receive from their own
Medicare carriers so they can keep track of news from their
carriers affecting claims processing and payment rates," AMA
But the most important thing you can do is to
call your senators
and ask your patients to call their senators and get them to pass
In addition, AMA has developed a document outlining physicians'
Medicare participation options
]. AMA is not advising or recommending any one of the three options
described in the document.
, July 1, 2008