California Physicians Face Ongoing Delay in Medicare Payments
Physicians in California and two other Western states are grappling with long delays in Medicare reimbursements, prompting some doctors to stop seeing Medicare beneficiaries, the Los Angeles Times reports.
For some doctors, the payment backlog can be traced to Medicare's move to a new universal identifier number required for reimbursement, while the delays in payments for other physicians stems from CMS' switch to a new Medicare claims processor for California, Nevada and Hawaii (Yoshino, Los Angeles Times, 11/8).
The move to the universal identifier number occurred in May, and Medicare switched its claims processor from National Heritage Insurance to Palmetto GBA two months later (California Healthline, 10/6).
The California Medical Association has taken calls from more than 1,000 doctors seeking help with delayed reimbursements.
Palmetto Complaints
Rep. Henry Waxman (D-Calif.) said the switch to a new claims processor has been "marred by missteps."
Mike Barlow -- Palmetto vice president who oversees California, Nevada and Hawaii -- said company officials are aware of issues and have worked to address them, including increasing staffing to field calls from physician offices.
Some critics fault CMS for making two large transitions within months of each other and argue that the agency chose Palmetto in an effort to cut costs.
CMS officials defended the choice of Palmetto (Los Angeles Times, 11/8). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.