BC Advantage - 2021 Issue 4

Why Will Medicare Administrative Contractors be Holding Claims Up?

When Congress passed the expansive American Rescue Plan Act recently, most Americans were focused on the direct payment provision of the bill. However healthcare administrators and policymakers had their attention on another aspect: cuts to Medicare payments. Why would Congress be cutting Medicare payments during the COVID-19 Public Health Emergency (PHE), when the costs borne by healthcare providers and facilities have been so great? Two reasons: a budget provision called PAYGO and the ever-looming sequestration cuts.Increased spending associated with the stimulus package triggered a 4% cut in Medicare payments.As defined by the Tax Policy Center, "PAYGO,"...

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