Hold Medicare Claims, AOA Washington Office Advises

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Eye Health / Blindness
Article Date: 01 Jul 2008 - 5:00 PDT

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The AOA Washington Office recommends that optometrists hold Medicare claims, with dates of service on or after July 1, until Congress completes action on AOA-backed legislation to correct Medicare physician payment cuts. The Bush Administration has issued an executive order imposing a 10-day freeze on Medicare physician payment levels. The action effectively blocks a 10.6 percent cut in Medicare physician payments that was scheduled to take effect July 1, 2008.

The U.S. Centers for Medicare and Medicaid Services (CMS) has instructed carriers to hold claims for services provided during the first ten days of this month (see related article). In addition, the CMS has not yet specified what procedures health care providers will need to follow should the freeze expire before Congress can pass legislation providing a longer-term Medicare payment fix, the AOA Washington Office notes.

The White House issued the executive order for a temporary 10-day pay freeze after Congress, last month, failed to pass the AOA-backed Medicare Improvements for Patients and Providers Act (HR 6331). That legislation would forestall any Medicare pay cuts for 18 months, providing physicians a 1.1 percent payment increase next year instead. The House last month approved the measure by a margin of 355 to 59, a veto-proof majority. However, the Senate rejected the bill by vote of 58 to 40 a few days later. Congress is expected to vote on HR 6331 again during the week of July 7, after lawmakers return from a Fourth of July recess.

AOA members will be kept informed of any Congressional action on the legislation and any steps that optometrists may need to take to ensure they receive full and proper payment for Medicare claims. AOA members should regularly check the AOA's e-newsletters (AOA First Look and the AOA Washington Report), the AOA Web site (http://www.aoa.org) and AOA News for timely updates.

American Optometric Association.