CMS Places Temporary Pause on Medicare Sequester Cuts Pending Congressional Action

WASHINGTON, D.C. (March 31, 2021)—Last week, the Senate passed an amended version of H.R. 1868, extending the pause on 2% Medicare sequester cuts though the end of 2021. Without Congressional action, those cuts would go back into effect on April 1.

With the House currently in recess, the Centers for Medicare & Medicaid Services (CMS) has just announced that they will hold claims with dates of service on or after April 1 “for a short time” to give Congress time to finish work on the measure. The House returns on April 13, and is expected to approve the amended version of H.R 1868.

The full MLN Connects statement from CMS reads as follows:
Temporary Claims Hold Pending Congressional Action to Extend 2% Sequester Reduction Suspension—In anticipation of possible Congressional action to extend the 2% sequester reduction suspension, we instructed the Medicare Administrative Contractors (MACs) to hold all claims with dates of service on or after April 1, 2021, for a short period without affecting providers’ cash flow. This will minimize the volume of claims the MACs must reprocess if Congress extends the suspension; the MACs will automatically reprocess any claims paid with the reduction applied if necessary. 

“Thanks to the strong grassroots advocacy of the HME community and coordinated efforts of our coalition partners, healthcare providers are poised to receive much-needed relief to help offset the increased costs and operational challenges we face in this pandemic for another nine months,” said Tom Ryan, AAHomecare president and CEO. “Leaders on Capitol Hill who have made this issue a priority also deserve credit, especially Senators Jeanne Shaheen and Susan Collins as well as Representatives Brad Schneider, David McKinley, and John Yarmuth.”

Once the House finalizes the measure, AAHomecare will ask HME stakeholders to increase advocacy efforts to waive potential 4% Medicare cuts for 2022 related to “pay-as-you-go” legislation from a decade ago that could be applied to the most recent round of COVID-19 relief.