CHA News Article

CMS Offers Additional Guidance on Payment Cuts from Sequestration

The Centers for Medicare & Medicaid Services (CMS) sent a notice to providers last week more fully outlining the effect of sequestration on Medicare fee-for-service (FFS) payments. According to the notice, in general Medicare FFS claims with dates-of-service or dates-of-discharge on or after April 1, 2013, will incur a 2 percent payment reduction, applied to all claims after determining coinsurance, any applicable deductible, and any applicable Medicare secondary payment adjustments. CMS notes that while beneficiary payments for deductibles and coinsurance are not subject to the 2 percent payment reduction, Medicare’s payment to beneficiaries for unassigned claims is subject to the 2 percent reduction. Providers who bill claims on an unassigned basis should discuss with beneficiaries the impact of sequestration on Medicare’s reimbursement. CMS directed any questions regarding reimbursement to the provider’s Medicare claims administration contractor.

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