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Accelerated and Advance Payments Program for Medicare Providers
April 03, 2020


All articles in this COVID-19 Response Resource issue are effective as of April 3, 2020.

The shutdowns caused by the coronavirus emergency have caused significant cash flow problems for many health care providers, as many medical treatments and procedures have been delayed due to the ongoing crisis.  

To help with this cash flow crunch, the Centers for Medicare & Medicaid Services (CMS) has announced the expansion of its accelerated and advance payment program for Medicare providers and suppliers. This effort is designed to help Medicare providers have the resources needed to fight the 2019 Novel Coronavirus (COVID-19) as part of the recently enacted CARES Act.  

Information regarding this program is available in a Fact Sheet recently released by CMS. See “Fact Sheet: Expansion of the Accelerated and Advance Payments Program for Providers and Suppliers During COVID-19 Emergency,” https://www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-Sheet.pdf 

An accelerated or advance payment is an advance payment against future payments. These payments are normally meant to provide funds when there is a disruption or interruption in the processing of Medicare claims. However, these accelerated payments have also been available in emergency and disaster situations. In light of the current difficulties faced by the health care system, CMS has decided to allow Medicare participating providers to obtain accelerated and advance payments as part of the COVID-19 emergency. This opportunity will be available only for the duration of the public health emergency.  

To be eligible for the program, a Medicare provider or supplier must: (1) have billed Medicare for claims within 180 days immediately prior to the date of the request; (2) not be in bankruptcy, (3) not be under active medical review or a program integrity investigation, and (4) not have any outstanding Medicare overpayments.  

Most qualified providers and suppliers can request up to 100 percent of the Medicare payment amount for a three-month period. Certain hospitals can request up to 100 percent of the Medicare payment amount for a six-month period. Critical access hospitals can request up to 125 percent of their payment amount for a six-month period. 

CMS has stated that the Medicare Administrative Contractors (MACs) will work to review and issue the accelerated payments within seven (7) days of receiving the request. 

These accelerated payments must be repaid from future Medicare reimbursements. For most providers, repayment of these advances will begin 120 days after the issuance of the payment.  For those providers, the accelerated or advance payment will need to be paid back within 210 days from the date of the accelerated or advance payment. Some types of hospitals will be allowed up to one year to repay the balance of the accelerated payments.  

More information regarding this program can be found on websites of the MACs. For example, Noridian has an explanation of their program at:

https://med.noridianmedicare.com/web/jddme/topics/emergencies-disasters 

To take advantage of this program, Medicare providers simply need to use the request form that is available on the websites of the MACs, supply the information requested including the amount to be advanced, and submit the request form. 

For more information about this or other related matters, contact Lee Radford at (208) 528-5252 or send an email to lradford@parsonsbehle.com.

 

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