Update: CMS resumes Medicare claims processing and pauses Medicare sequestration

As a result of quick work by Congress, President Biden this week signed legislation to stop the 2 percent sequestration cuts to Medicare payments until Dec. 31. Medicare Administrative Contractors, who had been holding claims with dates of service beyond March 31, have been instructed to immediately begin processing claims, with payments beginning as soon as April 19.

On March 31, the Centers for Medicare & Medicaid Services (CMS) announced a temporary processing hold on all Medicare claims dated April 1 or later. The announcement was made in anticipation of legislation that passed this week to address Medicare sequestration.

Sequestration has been in place since 2013 to reduce Medicare program spending growth. Congress paused the Medicare sequester at the start of the pandemic to help support physicians facing major financial challenges due to the COVID-19 public health emergency. Recognizing the impact of an estimated $12.3 billion in Medicare reimbursement cuts over the next nine months, both houses of Congress had approved extensions of the 2 percent Medicare sequestration holiday.

ASPS deployed a comprehensive advocacy campaign in advance of the sequester to encourage the House and Senate to pass a legislative solution immediately, so physicians received fair reimbursement for their Medicare claims. However, Congress did so through separate, distinct bills – meaning physicians had to wait until the House returned from its Easter and Passover recess on April 13 for a definitive solution.