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CMS to make cash payments to healthcare providers now

Mar 28, 2020

UPDATED: March 31, 2020

Just 24 hours after the President signed the CARES Act into law, the Centers for Medicare & Medicaid Services (CMS) expanded the scope of its Accelerated and Advance Payment Program to include additional Part A providers and Part B suppliers. CMS outlined the program expansion in a fact sheet.

The accelerated payments are intended to provide immediate cash flow relief to providers and suppliers focused on treating the flood of COVID patients.

Who may apply?

Any Part A provider or Part B supplier is eligible to submit a request and receive payment, provided the provider/supplier:

(i) has billed Medicare within the previous 180 days;
(ii) is not in bankruptcy;
(iii) is not under active medical review or program integrity investigation; and
(iv) does not have any outstanding delinquent Medicare overpayments.

How are requests for accelerated payments submitted and paid?

Each MAC has a separate request process, and the MACs are expected to review a form and issue payment with seven (7) calendar days of receiving the accelerated payment request. The request forms are quite concise and straightforward, and the following list includes links to example forms:

What is the amount of the accelerated payment?

Most Part A providers and Part B suppliers may request a specific amount up to 100 percent (or 125 percent for Critical Access Hospitals (CAHs)) of the Medicare payment amount for a three-month period.

When must the accelerated payment be repaid?

Accelerated payments must be repaid: (i) within one year from the date of payment for acute care hospitals, children’s hospitals, select cancer hospitals, and CAHs; or (ii) 210 days from the date of payment for all other Part A providers and Part B suppliers. At the end of the repayment period, the relevant MAC will send a repayment request for the remaining balance, and the provider or supplier is expected to pay the balance directly.

Does a request for an accelerated payment disrupt claim submission?

No. A provider or supplier can continue submitting claims after issuance of an accelerated payment. These payments will be paid in full until the recoupment process begins.

What is the recoupment process?

Beginning 120 days after the accelerated payment is made, the MAC will offset claims submitted by a provider and supplier against the outstanding balance of the accelerated payment. However, for Part A providers that receive a Period Interim Payment (POP), this reconciliation process will happen during the final cost repost process.

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