CMS temporarily holding payments after January 1

The Center for Medicare Services (CMS) sent out an email to the Ambulance listserve yesterday stating that they were instructing the Medicare Administrative Contractors (MAC) to hold payments pending an update to provisions of the Social Security Act that have increased payments for ambulance services.  The current law expires December 31st and the update was delayed by the current fight over the payroll tax extension.

CMS is stating that cash flow should not be affected . . . right now because of the 14 day timeframe for payment.  I’m not necessarily convinced that a fix will occur politically, so ambulance suppliers should work towards making sure they can live without cash flow from CMS for at least a couple of months.

The email from CMS is after the jump:

Attention Ambulance Services Suppliers: Information Regarding the Holding of 2012 Date-of-Service Claims for Services Paid Under the 2012 Medicare Ambulance Fee Schedule (MAFS) – Congress is considering legislation to extend certain expiring provisions of the Social Security Act that have increased payments for ground and air ambulance services. These provisions expire six business days from today. Pending action by Congress, the 2012 MAFS will not include increased fee schedule amounts that reflect the expiring provisions.

However, because CMS anticipates that Congress may extend the expiring provisions, CMS is instructing its Medicare claims administration contractors to hold claims containing 2012 services paid under the Medicare Ambulance Fee Schedule for the first 10 business days of January (i.e., January 1, 2012, through January 17, 2012). The hold should have minimal impact on supplier cash flow because, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt.

Ambulance claims for services furnished on or before December 31, 2011, are unaffected by the 2012 claims hold and will be processed and paid under normal procedures and time frames.

CMS will notify contractors on or before January 11, 2012, with more information about the status of Congressional action concerning the expiring provisions and next steps regarding the claims hold.

CMS Learn Resource 201112-45

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