Sequestration fee reductions for Medicare Advantage professional providers

As a result of the reimbursement reductions at the federal Centers for Medicare & Medicaid Services due to the budgetary sequestration, Blue Cross Blue Shield of Michigan will implement a 0.5 percent payment reduction effective Jan. 1, 2014. This is in addition to the current 2 percent payment reduction.

The original 2 percent sequestration reduction was planned for implementation by April 1, 2013. However, based on our provider contractual agreements, BCBSM is required to provide a 90-day notice before initiating these types of changes. Therefore, our sequestration reduction wasn’t implemented until July 1, 2013.

To offset the 90-day delay in implementation, we will increase the sequestration reduction by 0.5 percent, effective Jan. 1, 2014.

This sequestration reduction applies to the paid amount for both network and non-network providers. Further details are included in the applicable provider network agreements.

If there are no further changes in CMS guidance, the 0.5 percent reduction will be discontinued on Dec. 31, 2014.

This information was also detailed in a Sept. 30, 2013, web-DENIS message.

Questions about this reimbursement reduction can be directed to your BCBSM provider consultant.