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How to get medicare claims paid without sequestration reduction.

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Biller2023

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Trenton, NJ
Does medicare do sequestration on all medicare claims for all practices/providers? Should the provider do something in order to get the claims paid without sequestration reduction.
 
The sequestration reduction is based off the provider not providing the appropriate MIPS documentation for the previous years. There is a way to attest through your EMR company, but I am unsure of how to do this. If you are always doing something specific like taking BP or weights or providing smoking cessation, etc, the provider can make a statement of attestation and possibly get this removed for the upcoming years. There are rules that have to be followed in order to not get that reduction year after year unfortunately. Hope this helps!
 
mkdred07 said:
The sequestration reduction is based off the provider not providing the appropriate MIPS documentation for the previous years. There is a way to attest through your EMR company, but I am unsure of how to do this. If you are always doing something specific like taking BP or weights or providing smoking cessation, etc, the provider can make a statement of attestation and possibly get this removed for the upcoming years. There are rules that have to be followed in order to not get that reduction year after year unfortunately. Hope this helps!
Click to expand...

That's not sequestration. You're describing MIPS penalties. Sequestration is something different.
 
Biller2023 said:
Does medicare do sequestration on all medicare claims for all practices/providers? Should the provider do something in order to get the claims paid without sequestration reduction.
Click to expand...

Medicare sequestration is a mandatory 2% reduction for all Medicare Fee-for-Service claims.

It was part of the Budget Control Act of 2011, and went into effect on April 1, 2013. (Although it was temporarily suspended during the pandemic as part of the CARES Act.)


Novitas has a pretty good fact sheet about sequestration:


The American Hospital Association also has additional information:

 
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