CMS Expands Accelerated and Advance Payment Program to Assist Providers

April 1, 2020 | Health Services

As healthcare providers continue to fight the coronavirus outbreak, many practices are suffering major disruptions due to the cancellation of elective surgeries and office visits, among other things. In an effort to lessen the financial hardships facing these providers, on March 28 the Centers for Medicare & Medicaid Services (CMS) announced an expansion of its accelerated and advance payment program for Medicare participating healthcare providers and suppliers.

Historically, accelerated and advance Medicare payments provided emergency funding in order to help alleviate cash flow issues caused by disruptions in claim submissions and processing that result from a natural disaster. CMS is now expanding the program for all Medicare providers during the COVID-19 public health emergency.

The payments may be requested by hospitals, doctors, durable medical equipment suppliers, and other Medicare Part A and Part B providers and suppliers. A step-by-step guide on how to request accelerated or advance payment can be found in the CMS fact sheet. In order to qualify, the provider or supplier must:

  • have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/supplier’s request form;
  • not be in bankruptcy;
  • not be under active medical review or program integrity investigation; and
  • not have any outstanding delinquent Medicare overpayments.

Qualified providers/suppliers will be asked to request a specific payment amount using an Accelerated or Advance Payment Request Form provided on the website of each Medicare Administrative Contractor (MAC). Providers and suppliers may locate their designated MAC at this website. Most providers and suppliers will be eligible to request up to 100% of their Medicare payment amount for a three-month period, while hospitals will be able to request up to 100% of their payment amount for a six-month period (or up to 125% for critical access hospitals). Medicare will begin processing payment requests immediately, with payments to be issued within seven days of a provider’s request.

Most Part A providers and Part B suppliers will have 210 days from the date the accelerated or advance payment was made to repay the balance, while hospitals will have up to one year. The repayment will take place via a recoupment and reconciliation process which will begin 120 days after the issuance of the accelerated or advance payment.

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  • Margarita Christoforou

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