FOR IMMEDIATE RELEASE:
October 21, 2025

Media Contact:
Samantha Tirado
Director, Policy Communications
stirado@mgma.org 
 

MGMA Calls on CMS to Lift Claims Hold on Affected Medicare Part-B Claims 

Today marks three weeks since Congress allowed key healthcare policies to expire at the end of September. Since that time, CMS has held all Medicare physician claims for approximately half of the geographic areas in the country, as well as claims for telehealth and other expired policies, under the Full-Year Continuing Appropriations and Extensions Act of 2025. While we initially understood the need to prevent unnecessary claims reprocessing on a short-term basis, CMS has now created a situation that will significantly impact the nation's medical practices. 

MGMA calls on CMS to lift its claims hold on affected Medicare Part-B claims. The Agency has the authority to pay Medicare Part B claims regardless of Congressional negotiations on government funding. The current claims hold is significantly impacting physician practice cash flow and having a detrimental effect on practice operations in over half the country. Like any business, medical groups must continue to pay staff, purchase supplies, pay rent, and keep the lights on. The issue of whether to submit claims subject to future reprocessing should be at the discretion of physician practices, not CMS. An extended claims hold of this magnitude will have a devastating impact on medical groups with large numbers of Medicare patients, including many specialties, practices in rural/underserved areas, and independent practices. 

About MGMA

Founded in 1926, the Medical Group Management Association (MGMA) is the nation's largest association focused on the business of medical practice management. MGMA consists of 15,000 group medical practices ranging from small private medical practices to large national health systems representing more than 350,000 physicians. MGMA helps nearly 60,000 medical practice leaders and the healthcare community solve the business challenges of running practices so that they can focus on providing outstanding patient care. Specifically, MGMA helps its members innovate and improve profitability and financial sustainability, and it provides the gold standard on industry benchmarks such as physician compensation. The association also advocates extensively on its members' behalf on national regulatory and policy issues.