Sequestration Resumes for Medicare Providers

The Protecting Medicare and American Farmers from Sequester Cuts Act impacts payments for all Medicare fee-for-service claims. As a result of this Act, a suspension on the sequestration was put in place due to the COVID-19 public health emergency (PHE.) The sequestration was suspended through March 31, 2022.

Effective April 1, 2022, the one percent sequestration payment adjustment will be applied for claims with dates of services from April 1, 2022 to June 30, 2022.

Of note, the sequestration payment adjustment will revert to the two percent rate for claims with dates of services as of July 1, 2022. This will bring the total sequestration rate to two percent, which was the rate in effect prior to the PHE.

For home health providers, the adjustment applies to the respective “through” date on the claim.

The sequestration payment adjustment decrease will appear on the RA with a CARC 253, used to report the sequestration reduction. The code will appear as a CO 253 on the RA “Sequestration – reduction in federal payment” as the reason.

Sequestration Resumes for Medicare Providers

The Protecting Medicare and American Farmers from Sequester Cuts Act impacts payments for all Medicare fee-for-service claims. As a result of this Act, a suspension on the sequestration was put in place due to the COVID-19 public health emergency (PHE.) The sequestration was suspended through March 31, 2022. Effective April 1, 2022, the one percent sequestration…

NAHC to Congress: Extend Medicare Sequester Moratorium This Month

The National Association for Home Care & Hospice (NAHC), joined by a group of likeminded organizations, has written to congressional leaders to urge them to extend the current two percent Medicare sequester moratorium for the duration of the COVID-19 PHE, and to take action before April 1 when sequestration is scheduled to resume.

NAHC appreciates the bipartisan enactment of The Protecting Medicare and American Farmers from Sequester Cuts Act in December 2021, which extended the suspension of Medicare sequestration cuts, pursuant to The Coronavirus Aid, Relief, and Economic Security (CARES) Act. Suppressing sequestration has provided critical relief in our ongoing battle against COVID-19 and its variants, including Omicron, and enabled health care providers across the country to continue serving their patients and communities. We believe it is time for Congress to revisit the extension’s prescribed structure under which sequestration payment reductions will soon resume, and instead extend the full two percent Medicare sequester moratorium for the duration of the COVID-19 Public Health Emergency (PHE).

Since the beginning of the COVID-19 pandemic, Congress has ensured that frontline health care providers have the resources necessary to keep our doors open to care for both COVID and non-COVID patients alike. While we are encouraged that the worst days of the Omicron variant are hopefully behind us, it is also abundantly clear that daily COVID infection rates, hospitalizations, and deaths remain exceedingly high. Though we strive towards learning to live with COVID in an endemic state, it is likely premature to declare victory over the pandemic.

On February 18, President Biden renewed the COVID-19 National Emergency declaration beyond March 1, 2022, writing that “more than 900,000 people in this Nation have perished from the disease, and it is essential to continue to combat and respond to COVID-19 with the full capacity and capability of the Federal Government.” Along those lines, the U.S. Department of Health and Human Services (HHS) has recently indicated that the COVID-19 PHE will likely be renewed for an additional 90 days beyond the current expiration date in April 2022.

The Protecting Medicare and American Farmers from Sequester Cuts Act authorized a three-month delay of two percent Medicare sequester payment reductions (January 1, 2022 – March 31, 2022), followed by a three-month, one percent reduction in Medicare sequester payment reductions (April 1, 2022 – June 30, 2022). The resumption of the Medicare sequester before the end of the PHE would unnecessarily hinder our caregiving abilities, especially when the emergence of a new, potentially more dangerous and/or contagious variant continues to loom.

Consequently, NAHC believes it is vitally important to extend the current two percent Medicare sequester moratorium for the duration of the COVID-19 PHE, and to take action before April 1 when sequestration is scheduled to resume.

Full list of organizations signing the letter:

  1. National Association for Home Care & Hospice
  2. Ambulatory Surgery Center Association
  3. American Academy of Dermatology Association
  4. American Academy of Family Physicians
  5. American Academy of Ophthalmology
  6. American Academy of Physical Medicine & Rehabilitation
  7. American Association for Homecare
  8. American Association of Nurse Anesthesiology
  9. American Association of Orthopaedic Surgeons
  10. American College of Allergy, Asthma & Immunology
  11. American College of Gastroenterology
  12. American College of Osteopathic Family Physicians
  13. American College of Radiology
  14. American College of Surgeons
  15. American Medical Association
  16. American Medical Group Association
  17. American Nurses Association
  18. American Optometric Association
  19. American Physical Therapy Association
  20. American Society for Radiation Oncology
  21. American Society of Anesthesiologists
  22. American Speech-Language-Hearing Association
  23. America’s Essential Hospitals
  24. Association of American Medical Colleges
  25. Better Medicare Alliance
  26. Blue Cross Blue Shield Association
  27. Brain Injury Association of America
  28. Federation of American Hospitals
  29. Healthcare Leadership Council
  30. LeadingAge
  31. Medical Group Management Association
  32. National Association for the Support of Long Term Care
  33. Outpatient Ophthalmic Surgery Society
  34. Premier healthcare alliance
  35. Private Practice Section of the American Physical Therapy Association
  36. Vizient, Inc.

NAHC to Congress: Extend Medicare Sequester Moratorium This Month

The National Association for Home Care & Hospice (NAHC), joined by a group of likeminded organizations, has written to congressional leaders to urge them to extend the current two percent Medicare sequester moratorium for the duration of the COVID-19 PHE, and to take action before April 1 when sequestration is scheduled to resume. NAHC appreciates the…