The federal government is warning Congress that it must take action on Medicare’s “doc fix” issue before April 15 or thousands of Medicare doctors nationwide will face double-digit cuts.
The Centers for Medicare and Medicaid Services (CMS) told providers Wednesday that it will hold onto their checks for two weeks after Congress missed its deadline to prevent a 21 percent payment cut that goes into effect Wednesday.
The agency can delay payments for up to 14 calendar days under current law to temporarily shield doctors from the cutbacks, a move that has also been endorsed by several members of Congress whose efforts at a deal fell short last week.
“Any delay in processing claims beyond April 15 would negatively impact providers’ cash flow,” a CMS official wrote in a statement.
The annual payment cuts are triggered by Medicare’s much-maligned “sustainable growth rate” formula, also known as SGR, which Congress has tried to repeal for nearly two decades.
A $200 billion bill to repeal the SGR had sailed through the House on a huge bipartisan vote Thursday, and it appeared to many in Congress that the Senate would pass the bill before leaving town for a two-week recess.
Instead, a small core of opposition forced Senate leaders to hold off on the vote until at least April 13. If the Senate fails to pass the bill before April 15, CMS said it will be forced to put the payment cuts into effect, though the agency said doctors could be retroactively repaid.
“Should Congress act subsequently, CMS will reprocess those claims paid at the lower payment rate to reflect the new payment rates,” an agency official said.
Officials at CMS said last week that they were already preparing to make the 21 percent cuts if Congress does not act.