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  2006 Medicare Physician Payment Update and
Claims Processing—Q & A

Medicare/Medicaid Updates

CMS last week announced plans to reprocess Medicare claims later this year to erase a 4.4% reduction in payments to providers that took effect Jan. 1 if Congress approves a freeze instead of a cut in rates.

Congress late last month approved the fiscal year 2006 spending cut package (S 1932), which contains a provision to freeze provider payments at current rates instead of cutting them by 4.4%. However, in approving the bill, the Senate also made several changes to provisions, forcing the legislation back to the House for approval before it can be signed by President Bush (Kaiser Daily Health Policy Report, 12/22/05). House members are expected to vote on the measure after they return from the winter break, but CMS was required to go forward with the payment cut as scheduled. In a Jan. 6 letter to House Ways and Means Committee Chair Bill Thomas (R-Calif.) Herb Kuhn, director of the CMS Center for Medicare Management, said CMS will automatically reprocess all provider claims paid at the lower rate once the budget measure is approved. He added, "Physicians and other providers will not need to resubmit their claims." CMS will combine claims, so that each provider receives a single payment to offset the cut. Kuhn noted that reprocessing could take until July 1 because of the expected volume of claims before the budget bill is signed. He said doctors who chose to stop accepting Medicare beneficiaries because of the payment cut will be given a 45-day re-enrollment period in which they can rejoin the program.

Reposted from the: Kaiser Daily Health Policy Report