CHA News Article

CMS Updates Providers on Interim Status of Expiring Provisions
Probe and educate process extended through April 30

The Centers for Medicare & Medicaid Services (CMS) sent a notice today advising providers about the status of expiring Medicare provisions in the absence of the Senate’s passage of the Medicare Access and CHIP Reauthorization Act (MACRA). Notably, CMS will continue to prohibit recovery auditor inpatient hospital patient status reviews for dates of admission occurring between Oct. 1, 2013, and April 30, 2015. In addition, CMS will continue the inpatient probe and educate process through April 30. However, while MACRA extends the low-volume hospital payment adjustment and Medicare-dependent hospital program through Oct. 1, 2017, the provisions expire today under current law. Additionally, under current law, exceptions to the therapy caps, which are allowed for reasonable and necessary therapy services above the caps, will be considered only for dates of service through March 31.

Last week, CMS notified providers it will hold physician payments for 14 days, avoiding the 21 percent payment reduction until the Senate returns from its recess April 13.