April 2, 2014 | Comments Off on SGR Patch
Posted by Frank Ciesla
Both the House and the Senate have now passed a temporary patch to the Sustainable Growth Rate (“SGR”) for the next year. See our prior blog as to the action, which also defers the implementation of IDC-10 for a year. It is expected that the White House will sign the extension. In anticipation, CMS has instructed the Medicare administrative contractors to hold claims containing services paid under the MPFS for the first 10 business days of April. This hold would only affect MPFS claims with dates of service of April 1 and later. It is expected by CMS that the hold will have minimal impact on provider cash flow, because under current law, clean electronic claims will not be paid any sooner than 14 calendar days after the date of receipt. All claims for services delivered on or before March 31st will be processed and paid under the normal procedures, regardless of whether or not the President now signs the legislation extending the patch for another year.
Hopefully during this period of time, a permanent solution of the SGR will be agreed upon by the House, the Senate and the White House. However, at this point in time, there does not appear to be an acceptable funding source for the payment of the solution. We will be looking forward, in the latter part of 2014, to a CBO estimate of what the cost will be going forward.