The Medicare Administrative Carrier (MAC) Highmark is reporting they processed Medicare claims with a conversion factor using the 21% sustainable growth rate (SGR) cut.  Initially, Highmark announced no claims were processed at the reduced rate. The MAC now says the cut went through because of an "internal system error."

"Systems corrections have been made, and claims paid at the incorrect -21% fee will be reprocessed automatically," Highmark says. "[The MAC] plans to continue releasing held claims on a first in first out basis, which will process with the correct fee schedule."

The error effects claims with dates of service from April 1 through April 7.  

Highmark is the MAC for Pennsylvania, Delaware, Maryland, New Jersey and the District of Columbia metro area.

Erase any thought you had of Donald Berwick, MD, breezing through the Senate confirmation process and into a corner office at CMS HQ. He's received support from Democrats and medical associations, but Republicans are mounting opposition to his bid for CMS administrator. 

Sen. John Barrasso, MD, (R-Wyo.) took to the Senate floor April 21 and warned Americans that Dr. Berwick supports rationing patient care. "He has a history of support for government rationing of health care resources on the grounds of cost," said Sen. Barrasso, who is a trained orthopedic surgeon. "Not on the grounds of quality, not on the grounds of survivability but on the grounds of cost. And he has said, as recently as last June, ‘the decision is not whether or not we will ration care.' he said, ‘the decision is whether we will ration with our eyes open.' So here we are, the newly nominated person has said, I'm going into this to ration care." [emphasis mine, CF]

Read more on Berwick opposition

A little known tweak to privacy rules will mean private practices get more unwanted publicity when they experience a HIPAA slip up.  

President Barack Obama nominated Donald Berwick, MD, of Massachusetts to be the next CMS administrator on April 19.

"Dr. Berwick has dedicated his career to improving outcomes for patients and providing better care at lower cost," Obama said in a statement from the White House. "That's one of the core missions facing our next CMS Administrator, and I'm confident that Don will be an outstanding leader for the agency and the millions of Americans it serves."

Dr. Berwick is president of the think tank the Institute for Healthcare Improvement and he is a professor at Harvard Medical School and the Harvard School of Public Health.

Read more on CMS nominee Berwick

It appears that almost no Part B claims wound up being processed at the reduced rate of -21%, even though Medicare contractors were technically supposed to begin processing claims at the lower rate on April 15. They had about one eight-hour business day to do so before Congress passed a pay-fix bill that reverses the cut effective to April 1 and lasting until May 31.