CMS Expands Accelerated/Advance Medicare Payment Program During COVID-19 Public Health Emergency

In accordance with Section 3719 of the CARES Act, CMS has expanded its Accelerated and Advance Payment Program to a broader group of Medicare Part A providers and Part B suppliers during the COVID-19 public health emergency. In order to be eligible for these accelerated/advanced payments, providers/suppliers must:

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

Depending on the type of provider/supplier, the provider/supplier may request up to 100-125% of the Medicare payment amount for a 3-6 month period. This advanced payment would be based on net reimbursement represented by unbilled discharges or unpaid bills.

In order to apply, providers/suppliers are required to complete an Accelerated/Advance Payment Request form and submit it to your servicing MAC via mail or email (each MAC has its own form). If the request is approved, the payment will be issued by the MAC within seven (7) calendar days of receiving the request.

Repayment of these accelerated/advanced payments will begin 120 days after the issuance of the payment, with the deadline for repaying the balance between 210-365 days after the issuance of the payment. During the initial 120 days after receipt of the accelerated/advanced payment, providers/suppliers can continue to submit claims and will receive full payment. At the end of the 120-day period, CMS will begin to recoup the accelerated/advanced payment and every claim submitted by the provider/supplier will be offset from the new claims to repay the accelerated/advanced payment.

We are available to assist you in applying for these accelerated/advanced payments if your organization is experiencing cash flow issues as a result of its response to the COVID-19 crisis. Incomplete application forms will not be accepted by the MACs and will result in delays. More specific information about the application process can be found here.

For more information, please contact Kirsten McAuliffe Raleigh at 610.205.6015, or reach out to the Stevens & Lee attorney with whom you regularly work.

This News Alert has been prepared for informational purposes only and should not be construed as, and does not constitute, legal advice on any specific matter. For more information, please see the disclaimer.