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A hold will be placed on Medicare payments for ALL claims (e.g., initial claims, adjusted claims, and Medicare Secondary Payer claims) for the last 9 days of the Federal fiscal year - September 22, 2006 - September 30, 2006. These payment delays are mandated by section 5203 of the Deficit Reduction Act (DRA) of 2006.

No payments on claims will be made from September 22 – 30, 2006. Also, no interest will be accrued or paid, and no late penalty will be paid to an entity or individual for any delay in a payment by reason of this one-time hold on payments. ALL claims held as a result of this one-time policy will be paid on October 2, 2006. Payments will not be staggered and no advance payments during the 9-day hold will be allowed.

This policy applies only to claims subject to payment. It does not apply to full denials and no-pay claims. Also, it does not apply to periodic interim payments, home health request for anticipated payments; cost reports settlements, and other non-claim payments.

Medicare may make adjustments on a case-by-case basis, after October 1, 2006, for extenuating circumstances raised by a provider in that adjustments may be made to not charge a provider interest on an overpayment for those days for which offsets could not be made due to the hold of payments of the mandated DRA provision.

Medicare contractors will continue to apply the fourteen-day electronic claim payment floor and the 29-day paper claim payment floor. If you have any questions, please respond to this e-mail.

Amper’s Healthcare Services Group recommends that you consider the following suggestions to deal with this cash flow delay:

1. Set up a cash budget for the month of September
2. Try to delay payments at the end of September, until the first week of October
3. Make sure that all of your claims are being billed out timely and accurately