Provider updates

CareOregon Advantage to apply 2% CMS sequestration effective July 1, 2022

Jun 28, 2022, 07:00 AM

This update addresses the Senate passage of S. 610, regarding changes to the federal sequestration reduction in 2022.

In response to the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) temporarily suspended the planned 2% federal sequestration reduction in Medicare payments for dates of service effective May 1, 2020, through March 31, 2022. As a Medicare plan, CareOregon Advantage applied the temporary federal sequestration suspension increasing payments for services provided.

CMS has reinstated a 1% sequestration reduction effective April 1, 2022, and will return to a 2% sequestration reduction effective July 1, 2022.

At the time the sequestration was enacted, CareOregon Advantage decided to absorb the reduction in our premium payments from CMS and not apply these reductions to our delivery system. However, it is now clear sequestration will continue into the foreseeable future, and we have determined we must reinstate the 2% sequestration reduction effective July 1, 2022, to align with CMS.

Please note that the 2% sequestration will be applied to dates of service or dates of discharge on or after July 1, 2022.

If you have any questions concerning this issue, please do not hesitate to reach out to our Provider Customer Service at 800-224-4840, Monday through Friday, 8 a.m. to 5 p.m.