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Medicare Sequester Headed Back to 2 Percent

Barring a last-minute reprieve, entities billing Medicare should expect the return of the full 2 percent payment cut due to sequestration starting July 1st. This includes skilled nursing facilities (SNFs), certified home health agencies (CHHAs), hospices, Program of All-Inclusive Care for the Elderly (PACE) organizations, and Medicare Advantage plans (as well as physicians, durable medical equipment (DME) providers, etc.). The provision was suspended in May 2020 by the Coronavirus Aid, Relief, and Economic Security (CARES) Act and extended several times subsequently through March 2022. On April 1, 2022, the Centers for Medicare and Medicaid Services (CMS) began phasing the cut back in at 1 percent. The full 2 percent cut is scheduled to be back in effect on July 1, 2022.

The sequestration cut was originally enacted in 2011 and implemented in 2013. It is a payment cut that reduces the amount that providers and plans would otherwise receive in their reimbursement payments by 2 percent. Advocacy against all Medicare reductions continues.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841