WASHINGTON, D.C.—A 21 percent cut in Medicare physician payments went into effect last week on April 1, 2015. While Congress passed legislation intended to eliminate the automatic cut that resulted from the Medicare Sustainable Growth Rate (SGR) formula, the Senate failed to take action before its current two-week spring recess. In response, last week the American Optometric Association (AOA) released a statement informing optometrists how they can attempt to avoid being impacted by the cut until further action is taken.
 
On March 26, Congress passed H.R. 2: the Medicare Access and CHIP Reauthorization Act of 2015 to prevent the automatic 21 percent payment cut for doctors who treat Medicare patients. The bipartisan bill would replace Medicare’s SGR formula with a new merit-based incentive payment system. However, while Congress approved the bill, the Senate will not vote on the measure until after it returns from its spring recess on April 13. This means that technically with no stopgap measure that the automatic 21 percent cut to Medicare physician payments took effect on April 1.
 
However, there is still time for physicians, including optometrists, to prevent having their reimbursements cut. The U.S. Department of Health and Human Services announced that it would hold off processing claims at the lower rate until April 15.
 
Also, according to the AOA’s statement: “ODs and other Medicare physicians are unlikely to immediately feel the impact of this cut. By law, the Centers for Medicare & Medicaid Services (CMS) may not process and pay claims any sooner than 14 days. CMS does have the option of delaying claims until the Senate acts on the bill. CMS plans to update providers by April 11. In the meantime, AOA has advised members to hold off on submitting April claims for as long as practical, giving Congress time to complete the legislative process on H.R. 2 and Medicare contractors the ability to implement new payment rates. No processing or payment delays should occur for claims submitted to Medicare that are dated March 31 or earlier.”