Wednesday, December 21, 2011

Latest Update on Medicare Ambulance Relief Extensions

Both Chambers Pass the Bill
The Temporary Payroll Tax Cut Continuation Act of 2011, H.R. 3630 has now passed both the House and the Senate.  This bill, which also includes the extension of the ambulance bonus payments into the New Year, may now proceed to a conference committee of senators and representatives in order to work out the differences in the versions of the bill that each chamber approved.

This is basically the fight that you have been reading about in the newspapers that is so politically entwined.

Will There Be Compromise Before the Congressional Holiday Recess?
The answer to this question is…”highly unlikely.”

Just today, the Centers for Medicare and Medicaid Services (CMS) announced that they have plans already in place to delay payment for 2012 claims submitted by ambulance services across the first 10 business days of January (i.e., January 1 through January 17, 2012).

Because CMS anticipates that Congress may extend the expiring bonus payment provisions, CMS is instructing the Medicare Administrative Contractors (MAC’s) to hold claims containing 2012 services paid under the Medicare Ambulance Fee Schedule for this period.

Minimal Impact - At Least for Now
Because the payment floor for Medicare claims is currently 14 calendar days, most ambulance services should see minimal impact- that is unless the delays are extended. In addition, ambulance claims for services provided on or before December 31, 2011 are unaffected by this hold and will be processed by the MAC’s and also paid under normal time frames.

You may even be one of the suppliers that holds claims, anyway, during the first part of the New Year in order to minimize the amount of deductible assessments against your claims.  If so, then you’ve already budgeted and are prepared for any resulting “slowing” of Medicare reimbursement dollars to your department.

Next Update
CMS presumes they will provide further guidance to the ambulance supplier community by no later than January 11, 2012.  At that time CMS will announce the status of any renewed Congressional action following the holiday break and issue their plan to move forward by announcing the 2012 edition of the Medicare Ambulance Fee Schedule or, in the case that no compromise is reached, an extension of the claims hold order.

Keep watching this space as Enhanced Management Services strives to keep you informed on the latest developments.
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