Current processing issues
The tables below provide an at-a-glance look at processing issues being worked currently or resolved recently.
Open issues: Part A
| Last updated | Issue | Resolution | Provider action |
|---|---|---|---|
| 4/29/2026 |
Payment Issue: Starting April 17, 2026, through April 28, 2026, the two percent sequestration deduction is being incorrectly applied twice on various claims.
To identify the claims that are impacted, providers should review their remittance advice.
The sequestration field on the remittance is the correct amount.
The overapplied second amount, is displayed in the "Pre Pay Adj" field on the remittance. The final payment of the claim is incorrect by this dollar amount. |
The issue has been reported to the Fiscal Intermediary Shared System (FISS). We will provide updates as they become available.
At this time, there is no workaround and no provider action needed.
Update 5/5/26: An emergency correction was installed on April 28, 2026. Claims received after that date are processing with the correct sequestration amount.
We are working with FISS on identifying the incorrect claims and will automatically reprocess the claims.
We will post additional information on the adjustment process when it starts to occur.
Update 06/03/26: The adjustments have been initiated. Due to the volume of impacted claims, the adjustments will be released in smaller volumes, so they do not experience any delays. The claims will be released over the next several months. We will post a final update when all claims have been released. |
Open |
Closed issues: Part A
None at this time.
Open issues: Part B
| Date reported | Workload impacted | Description/claim coding impact | Proposed resolution/fix/action required | Status |
|---|---|---|---|---|
| 4/29/2026 | Part B | An issue has been identified involving claims pending in an approved to pay location for an extended period of time. This matter is being investigated as a high priority. | No provider action at this time. Update: Our system maintainer continues to work on a full resolution; most pending claims have now been finalized. Payments have already started going out, beginning with the May 11, 2026 cycle. |
Open |
Closed issues: Part B
| Last updated | Issue | Resolution | Provider action |
|---|---|---|---|
|
2/19/2026 |
We have identified claims being incorrectly rejected for invalid modifiers. |
Claim logic is being reviewed for possible maintenance. |
No provider action required at this time. |
|
2/13/2026 |
We have identified claims with contractor-priced codes not pricing correctly when processing and therefore the codes are denying. |
Claim logic is being reviewed for possible maintenance. |
No provider action required at this time. |