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Tag: Accelerated Payment

Law Eases Repayment Terms for Medicare Accelerated Payments

Today, the President signed into law a bill that includes easing of government funding rules for healthcare providers (Part A and B) to provide more time and flexibility for monetary relief to providers found cash-short due to the pandemic.

At the pandemic’s start, the Medicare accelerated payment program provided needed cash to providers for bolstering supplies and equipment to meet the anticipated COVID-19 needs. At the same time, cash-producing non-emergency and elective services were put on hold, leaving many short of funds for repayment of the loans. This law seeks to ease that strain.

Summary of Changes

  • The law extends the start of the recoupment process from 120 days to one year from the date the loan was issued
  • Payment withholding is reduced from 100% to 25% for the first 11 months and then 50% for the next 6 months
  • If full payment has not been made after 29 months from the date the loan was issued, interest will accrue on the unpaid balance
  • The law overrides the standard Medicare under/overpayment interest rate to a fixed rate of 4% 1

Please contact Fred Fisher at fred.fisher@toyonassociates.com with questions or to discuss more in-depth.

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1 CMS updates quarterly the stated interest rate for Medicare over/underpayments. The current interest rate for Q4 2020 is 9.5% per CMS Transmittal 10220.

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COVID-19 Accelerated Payments

CMS has expanded cash advances for most hospitals. Have you calculated your payment?
 
Updated 4/28/2020:
 
Please find a link to the CMs table that shows a State by State breakout of the accelerated payments as of Friday, April 24, 2020. CMS indicates they plan to update this information once a week on their website.
 

Updated 4/27/2020: 

Beginning on April 26, 2020, CMS will not be accepting any new applications for the Advance Payment Program, and CMS will be reevaluating all pending and new applications for Accelerated Payments.

 
Updated 4/8/2020 from original 3/30/2020 article:
 
CMS stated that they will prioritize the accelerated payments for states that were hit the hardest (CA, NY and WA).
 
In a little over a week, CMS has already authorized $34B in accelerated payments to providers, approving over 17,000 requests so far out of 25,000 received.  Prior to COVID-19, CMS has approved only 100 total requests for accelerated payments in the past five years, with most being tied to natural disasters such as hurricanes.
 
 
Expansion of Accelerated Payments
In order to increase cash flow to providers impacted by COVID-19, CMS has expanded the current Accelerated and Advance Payment Program to a broader group of providers for the duration of the public health emergency.
 
Who is Eligible?
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.
 
Please contact Robert Howey at robert.howey@toyonassociates.com or 888.514.9312 with any questions or for assistance calculating your expected payment.
 
Respectfully, 
Toyon Associates, Inc.

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