Government Shutdown Continues

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Medicare claims processing activities continue during the shutdown.   PRRB appeal deadlines, although temporarily suspended, will become due immediately on the day the government reopens.  Federal court deadlines remain in effect for the time being.  In civil cases in which the government is involved, however, it is likely that the government will seek and be granted extensions.  Below is a roundup of relevant information for providers.

Based upon information published by the Administrative Office of the United States Courts, all proceedings and deadlines remain in effect as scheduled, unless otherwise advised.  The Case Management/Electronic Case Files (CM/ECF) system will remain open for document filings during the shutdown.  “Following a government shutdown on October 1, 2013, the federal Judiciary will remain open for business for approximately 10 business days. On or around October 15, 2013, the Judiciary will reassess its situation and provide further guidance.”

The PRRB is closed.  The Board has announced that all deadlines that fall during the shutdown period will become due on the day the government reopens.  Because the shutdown could end with very little notice, it could pose a challenge for providers to timely submit filings on the day the Board reopens.  We recommend that providers with deadlines during the shutdown period continue to prepare all filings so that they are ready to submit to the Board on a moment’s notice.  We will be happy to assist clients in submitting filings by hand courier to the Board on the day that the government reopens.

The Department of Health and Human Services issued a contingency staffing plan, which is available here.  CMS has been pared down to essential personnel during the shutdown period, with regional offices reporting large numbers of personnel on furlough.  According to a notice released by CMS on October 1, “Medicare Administrative Contractors will continue to perform all functions related to Medicare fee-for-service claims processing and payment” during all periods affected by the shutdown, though slowdowns may be possible.  We note that provider enrollment deadlines remain in effect.  The shutdown will likely delay the anticipated publication of pending rules, such as the OPPS and MPFS rules, which ordinarily would have been published on November 1.

CMS is continuing implementation of the ACA, including coordination between Medicaid and the health exchanges, which opened on October 1, despite the government shutdown.  CMS’s nondiscretionary Health Care Fraud and Abuse Control activities, which include RACs, will continue, but CMS will not be able to continue discretionary funding for health care fraud and abuse strike force teams, and will perform fewer recertification and initial Medicare provider surveys.  Because much of OIG is funded through other than appropriations, such as portions of amounts recovered in fraud cases, most OIG employees continue to work.

According to its contingency plan, the Department of Justice has curtailed or postponed all civil litigation “to the extent that this can be done without compromising to a significant degree the safety of human life or the protection of property.”

The shutdown contingency plans for other federal agencies are available here.

Reporter, Susan Banks, Washington, D.C., +1 202 626 2953, sbanks@kslaw.com.

Topics:  Affordable Care Act, CMS, Government Shutdown, HHS, Medicare, PRRB

Published In: Elections & Politics Updates, Health Updates, Insurance Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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