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Sequestration › Medicare

Sequestration is a budget technique characterized by the implementation of automatic mandatory spending cuts if deficit levels exceed a certain threshold. The Budget Control Act of 2011 utilized sequestration to... more +
Sequestration is a budget technique characterized by the implementation of automatic mandatory spending cuts if deficit levels exceed a certain threshold. The Budget Control Act of 2011 utilized sequestration to encourage Congress to cut federal spending by 1.2 billion dollars. If Congress fails to make the specified funding cuts, sequestration will kick in and  automatic cuts will be made to the federal budget. A good portion of the slated cuts will come from the national security budget.  less -
King & Spalding

Bill Averting Medicare Sequester Cuts Enacted

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The House and Senate voted last week, and President Biden signed into law on December 10, 2021, a bill to delay looming reduction in Medicare rates set to take effect in 2022. The bill, the Protecting Medicare and American...more

Sheppard Mullin Richter & Hampton LLP

News Flash: Last Minute Congressional Action Saves Physicians from a Nearly 10% Cut to Medicare Payments

Sheppard Mullin Richter & Hampton LLP on

Physicians and other providers can take a deep breath as Congress has acted to prevent the trio of Medicare payment cuts that were set to take effect at the beginning of 2022—a 3.75% cut due to scheduled changes in the...more

Alston & Bird

Sequester Relief Extension Highlights Potential Reimbursement Cliff for Medicare Providers in 2022

Alston & Bird on

Medicare providers face a nearly 10% reimbursement cut in 2022. Our Health Care Legislative & Public Policy Team does the math and explains how a combination of sequester cuts and expiring reimbursement support could bring a...more

Arnall Golden Gregory LLP

Sequestration and the Hospice Cap 2.0: Pending Legislation May Extend the Sequestration Moratorium

Arnall Golden Gregory LLP on

In the wake of the government-wide sequestration cuts in 2011, the hospice industry was not spared. Medicare hospice payments were reduced by two percent in accordance with a sequestration order issued March 1, 2013, pursuant...more

Epstein Becker & Green

CARES Act Temporarily Suspends Sequestration: How Will It Affect Provider Reimbursement?

Epstein Becker & Green on

One of the many relief efforts contained in the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”), signed into law on March 27th, 2020, is a hiatus of sequestration as it applies to Medicare payments....more

King & Spalding

Suspension of the 2% Sequestration Reduction May Affect Commercial Payer Reimbursement

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Section 4408 of the CARES Act suspends the 2% sequestration reduction to payments under the Medicare program that have been in place since April 1, 2013. The suspension of sequestration in Medicare will run from May 1, 2020...more

K&L Gates LLP

COVID-19: Impact on Hospitals of the Temporary Elimination of the 2% Medicare Sequestration Cuts

K&L Gates LLP on

Certain provisions of the recent CARES Act impact how hospitals are reimbursed under original Fee-For-Service Medicare (i.e., Part A and Part B) and existing Medicare Advantage contracts. Specifically, the CARES Act...more

King & Spalding

Budget Deal to Limit Provider-Based Status, Extend Sequestration

King & Spalding on

On October 28 and 30, 2015, the U.S. House of Representatives and U.S. Senate approved the Bipartisan Budget Act of 2015 (the Act)—a measure designed to raise the limit on Federal borrowing that would also have significant...more

McDermott Will & Emery

Congress Take Step Toward Site-Neutral Medicare Payments in Bipartisan Budget Act of 2015

McDermott Will & Emery on

On October 28, 2015, the U.S. House of Representatives approved legislation that, if enacted, would, among other things, substantially alter how and how much Medicare pays for outpatient services furnished by hospitals. The...more

Arnall Golden Gregory LLP

Hospice Cap Demand Group Appeal Deadline

Arnall Golden Gregory LLP on

As you likely are aware, Medicare hospice payments were reduced by two percent in accordance with a sequestration order issued March 1, 2013, pursuant to Section 251A of the Balanced Budget and Emergency Deficit Control Act....more

K&L Gates LLP

Pennsylvania Hospitals Successfully Challenge Sequestration Reductions

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In a case of first impression, a Pennsylvania court recently ruled in favor of 12 independent community hospitals (the “Hospitals”) that sued health insurer Highmark Inc. (“Highmark”) for passing on its 2 percent Medicare...more

Foley & Lardner LLP

Insurer Wrongfully Passed Sequestration Cuts Through to Providers

Foley & Lardner LLP on

A Pennsylvania judge found, on May 6, 2015, that a Medicare Advantage Plan had no right under its participation agreements to pass CMS sequestration reductions through to participating providers. Judge R. Stanton Wettick Jr....more

King & Spalding

Pennsylvania Hospitals Challenge Medicare Advantage Plan’s Sequestration Adjustment

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On September 22, 2014, twelve hospitals filed a complaint in a Pennsylvania state court against a Medicare Advantage plan, Highmark, Inc., along with its HMO subsidiary, for implementing a two-percent reduction to the...more

King & Spalding

Hospitals Speak Out Against Sequestration Extension

King & Spalding on

On Wednesday, February 12, 2014, the U.S. Senate passed legislation that, among other things, would further extend Medicare sequestration by one year (until 2024) in part to avoid a reduction in military pensions. Earlier in...more

King & Spalding

Medicare Providers React To New Congressional Budget Deal

King & Spalding on

A recent Congressional budget deal, the Bipartisan Budget Act of 2013, would exclude hospitals from sequester relief. Medicare provider payment cuts would be extended through 2023, two years longer than the cuts set by the...more

Sheppard Mullin Richter & Hampton LLP

New Budget Deal Can Bring Extension of Medicare Sequestration Cuts

Sheppard Mullin Richter & Hampton LLP on

While many in Washington, D.C. are celebrating today the unusual display of bipartisan budgetary comity as the new budget deal is announced, there is a direct and immediate adverse effect for hospitals and physicians. As...more

McDermott Will & Emery

Lawmakers Reach Deal to End Government Shutdown, Raise Debt Ceiling

McDermott Will & Emery on

While the focus over the past 16 days has been on the shuttered government and the prospect of the United States defaulting on its debt obligations, there are subtexts that are relevant to the health care industry. This On...more

King & Spalding

CMS to Congress: Sequestration of Cancer Drug Reimbursement to Continue

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A June 3, 2013 letter from CMS Administrator Marilyn Tavenner to Rep. Pete Sessions (R-Tex.) states that the agency does not believe it has any discretion under the Budget Control Act of 2011 to exempt Part B cancer drug...more

King & Spalding

Reported Errors in Calculation of 2 Percent Sequestration

King & Spalding on

One of King & Spalding’s clients reported to us that its Medicare contractor had not correctly calculated the 2 percent sequestration reduction in payments for purposes of biweekly pass-through payments. ...more

Nossaman LLP

Sequester the Sequestration Cuts, Please! Why the Health Care Industry Must Brace Itself for More Change...

Nossaman LLP on

As the federal government scrambles to cut burgeoning health care costs, yet increase health care coverage to the uninsured or underinsured, the paradox of expansion, on the one hand, yet constriction, on the other, has...more

King & Spalding

CMS Releases Sequestration Details; Medicare EHR Incentive Payments Subject to Two-Percent Reduction

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On March 8, 2013, CMS announced that it will apply the two-percent sequestration reduction to all Medicare provider payments with dates of service/discharge on or after April 1, 2013. The announcement also states that claims...more

King & Spalding

President Obama Issues Sequestration Order, CMS Has Yet to Publish Implementation Instructions

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On March 1, 2013, President Obama issued a sequestration order directing the Office of Management and Budget (OMB) to administer across-the-board cuts to federal spending. Concurrently, OMB issued a report to Congress...more

Cozen O'Connor

Health Care Reform Implementation Update - February 27, 2013

Cozen O'Connor on

As Washington and the rest of the country brace for cuts from the sequester to kick in on March 1, Florida Gov. Rick Scott surprised many and confirmed others' predictions by announcing his state will expand its Medical...more

Polsinelli

Health Reform + Related Health Policy News Update - January 24, 2013

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In This Issue: - OMB Directs Department Heads to Prepare for Sequestration - HHS Finalizes Omnibus HIPAA Rule, Enhances Privacy Requirements - SCOTUS Says Equitable Tolling Not a Factor in DSH Case - Report...more

King & Spalding

Important Medicare Provisions Contained in Fiscal Cliff Compromise

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On January 2, 2013, President Obama signed into law the American Taxpayer Relief Act of 2012 (ATRA), to avert the so-called fiscal cliff. While most popular coverage has focused on ATRA’s changes to the tax code, the new law...more

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