What Does SGR Repeal Mean for CT Physicians?

Before last night’s Senate vote to approve H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), there was a great deal of concern about the possible 21% cut to the Medicare Physician Fee Schedule (MPFS) for Medicare services provided on or after April 1, 2015. The President is expected to sign MACRA into law shortly, eliminating the scheduled 21% MPFS cut.

In an effort to minimize potential financial effects on providers, the Centers for Medicare and Medicaid Services (CMS) had previously instituted a 10-business day processing hold for all impacted claims with dates of service April 1, 2015, and later.

While the Medicare Administrative Contractors (MACs) have been instructed to implement the rates in the legislation, a small volume of claims will be processed at the reduced rate based on the negative update amount. The MACs will automatically reprocess claims paid at the reduced rate with the new payment rate. The MAC for Connecticut is National Government Services (NGS).

No action is necessary from providers who have already submitted claims for the impacted dates of service.

(Information from CMS.gov and NGS)

 

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