Medicare 2% sequestration moratorium extended to Dec. 31, 2021

President Biden signed legislation on April 14, 2021, that extends the suspension of the Medicare 2% sequestration reduction until the end of 2021. We’ve aligned with the Centers for Medicare & Medicaid Services and will extend the suspension of the 2% sequestration applied to Medicare Plus Blue℠ and BCN Advantage℠ claims through Dec. 31, 2021. Providers don’t need to take any action.

Background

Since 2013, 2% sequestration reimbursement reductions have been in place for our Medicare Advantage professional and facility providers. This is in accordance with the terms of our Medicare Advantage provider agreements that pay according to Original Medicare methodologies. The 2% reimbursement adjustment is applied after determining any applicable member deductible, copayment or other required member cost sharing.

Timeline

The timeline of the suspensions is as follows:

• May 1, 2020, through Dec. 31, 2020
  The Coronavirus Aid, Relief, and Economic Security (also known as CARES) Act suspended the 2% sequestration payment adjustment percentage applied to all Medicare Fee-for-Service claims to offer financial relief to providers during the COVID-19 pandemic.
• Jan. 1, 2021, through March 31, 2021
  The Consolidated Appropriations Act of 2021 extended the suspension period to March 31, 2021.
• April 1, 2021, through Dec. 31, 2021
  On April 14, 2021, H.R. 1868 was signed into law, extending the suspension period to Dec. 31, 2021.

Reimbursement to providers who haven’t been affected by sequestration previously, such as durable medical equipment, end-stage renal disease and lab providers, won’t be affected by this change.

We expect that CMS will reinstate the 2% sequestration reimbursement reduction on Jan. 1, 2022, but will alert you of any changes prior to that date.