Government Shutdown and CMS
Last week, I received an email from a long-term practice asking my thoughts on the government shutdown.
In a nutshell, here is what is said: Dr. _____ is concerned about the Medicare shut down and what we should do to prepare in regard to payments. Do you have any suggestions on this? Do we get money up front from patients? If there is a protocol you would suggest, we would love to know!
*Please note, my advice may change if the shutdown continues longer than this coming week, but for now, here was my response:
According to what I have read, there will be slight delays in payment but not a complete stop. You are not allowed to collect money “up front” from Medicare patients for services that are covered under CMS rules.
If you Google “Government shutdown affecting Medicare payments to providers” you can read more, including the blurb below (I will update you as needed).
“During a government shutdown, Medicare payments to providers generally continue because Medicare is funded by mandatory spending, which is not subject to annual appropriations. However, providers may experience slight administrative delays or issues with specific programs that rely on discretionary funding.
Key Impacts on Providers
- Payments Continue with Minor Delay: Medicare Administrative Contractors (MACs) are instructed to place a temporary hold on processing some claims (typically up to 10 business days) during a shutdown. This is a routine measure to prevent reprocessing claims in case Congress later acts to retroactively extend expiring programs. Due to the existing 14-day payment floor for electronic claims, the impact on provider reimbursements is expected to be minimal, though payments may be slightly delayed.
- Continued Claims Submission: Providers can continue to submit claims during this period.”
