It's likely that the APTA-supported moratorium on the 2% sequester reduction to payment under Medicare will continue past a March 31 deadline — but nothing is final yet, and PTs may have to ride out a few weeks of the cuts being in effect temporarily.
On March 25, the U.S. Senate passed a compromise bill that extends a suspension of cuts that have been taking place since 2013 as part of the "sequester" mechanism aimed at deficit reduction. The legislation, led by Sens. Jean Shaheen, D-N.H., and Susan Collins, R-Me., puts the sequestration cuts on pause through the end of 2021.
Continuing the moratorium amounts to a 2% boost to anticipated Medicare payment, which originally was introduced in the CARES Act of 2020. That law — the first major COVID-19-related relief legislation — included a temporary moratorium on the 2% sequestration reduction, with a Dec. 31, 2020, expiration date. In December Congress extended that expiration to March 31, 2021.
Earlier this week, the U.S. House of Representatives passed legislation that would continue the moratorium until the end of the public health emergency; the bill approved in the Senate is widely viewed as a compromise. APTA expects the Senate version to be approved in the House and signed into law by President Biden.
There's just one catch: The House needs to vote on the Senate compromise but isn't currently in session, and won't return until mid-April. That means the March 31 deadline for the end to the moratorium would still be in effect, creating a temporary gap during which the 2% sequestration technically will return.
Justin Elliott, APTA vice president of government affairs, says that APTA is now trying to get clarity from the U.S. Centers for Medicare & Medicaid Services on how it will handle the gap between the expiration of the moratorium on March 31 and the enactment of the moratorium extension sometime in April.
"It is possible that CMS will hold claims submitted on and after April 1 until the extension is enacted or will retroactively reprocess the claims, but CMS hasn't indicated what it plans to do yet," Elliott said. "We are seeking clarification, and we'll share developments as they happen."