Government shutdown to have minimal impact on Medicare and TRICARE programs

October 03, 2013
Area(s) of Interest: Payor Issues and Reimbursement Public Payors 

With the October 1 shutdown of the federal government, the California Medical Association (CMA) has received calls from physicians with questions about how federally funded programs like Medicare and TRICARE will be affected.


On October 1, 2013, the Defense Health Agency issued a statement regarding TRICARE programs, indicating that there will be minimal impact to TRICARE beneficiaries utilizing private sector physicians. CMA has also confirmed with United Healthcare Military & Veterans Services, the managed care support contractor for the TRICARE West Region, that there should be no interruption in operations including utilization management and physician reimbursements.


On October 1, the Centers for Medicare and Medicaid Services (CMS) announced in its MLN Connects Provider eNews that while the government shutdown is in effect, Medicare Administrative Contractors will continue to perform all functions related to Medicare fee-for-service claims processing and payment. There should be no effect on payments to physicians.

CMA has also received questions about whether the PQRS payment adjustment exemption deadline of October 15 will be extended. CMS reports that neither the portal nor the help desk have been affected by the government shutdown. While CMS reports the portal was down briefly on October 3, the issue was resolved quickly. Slower response times are likely due to the increased volume of providers trying to access the system as the deadline approaches.

Contact: Michele Kelly, (213) 226-0338 or mkelly@cmadocs.org.


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