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CMS will hold claims until 2% sequestration payment reduction vote

| March 31, 2021

CMS will hold claims until 2% sequestration payment reduction vote

Yesterday CMS announced that it will hold claims with a date of service on or after April 1 until Congress completes action to pass legislation that extends the temporary pause of the two percent Medicare sequestration payment reductions. Holding claims will prevent CMS from having to reprocess claims to restore the two percent that was withheld during the temporary expiration of the sequestration suspension.

Congress previously passed legislation that pauses sequestration through March. Last week, the Senate passed legislation to extend the sequestration suspension through the end of 2021. The House of Representatives is expected to pass the bill shortly after returning to D.C. from recess on April 12.

Because CMS already holds all claims for 14 days after receipt, MACs would not even begin to process claims submitted on April 1 (for services rendered on April 1) until April 15. It is possible for the House to pass the bill and President Biden to sign it into law before April 14 and avoid the temporary hold on claims.

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