To qualify for accelerated payments, the provider/supplier must:
- Have billed Medicare for claims within the last 180 days;
- Not be in bankruptcy;
- Not be under medical review or program integrity investigation; AND
- Not have any outstanding delinquent Medicare overpayments
How Much Will You Receive?
Most hospitals may receive up to 100% of their Medicare payment for a 6-month period. CAHs may receive up to 125% over that same period. All other providers may receive up to 100% for a 3-month period of Medicare payments.
How Does the Process Work?
Providers that meet the qualifications must submit the appropriate forms as designated by each MAC on their respective websites. The MACs will review and issue payments within seven calendar days of receipt. Repayment must begin 120 days after the date of issuance of the payment, via withholding of future claim payments. Most hospitals will have one year from the date the accelerated payment was received to repay the balance.
For further information, please refer to the complete CMS guidance
here.
Toyon’s Take:
Providers will need to review their individual MAC’s website in order to access the appropriate forms and procedures. Providers should also estimate their Medicare payments over the applicable period based on the most current data available, in order to verify the amount calculated by the MAC.
If you need assistance with that calculation, you may find the attached
template helpful. Alternatively, if it is administratively easy for your organization to do, you may also want to consider generating a report from your hospital billing system that will show payments received over the applicable period up through March 30, 2020. It is our understanding that CMS may be requesting that the MACs generate a report of actual payments out of HIGLAS for the applicable period, which would match this data source.
