Month / Year

Tag: COVID-19

COVID-19 Accelerated Payments

CMS has expanded cash advances for most hospitals. Have you calculated your payment?
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 or 888.514.9312 with any questions or for assistance calculating your expected payment.
Toyon Associates, Inc.

Back to top

COVID-19 President’s National Emergency Declaration CMS Fact Sheet

President’s National Emergency Declaration; CMS COVID-19 Fact Sheet
On March 13, 2020, the Centers for Medicare & Medicaid Services (CMS) published a fact sheet that outlines the impacts to healthcare providers from President Trump’s national emergency declaration. CMS is empowered to take proactive steps through 1135 waivers and rapidly expand the Administration’s aggressive efforts against COVID-19.
Overall, these regulatory changes are focused on addressing the potential shortage of beds needed to address the infected population. It appears that excess patient load may now be pushed into any available bed, including post-acute care settings by waiving patient and facility requirements. These changes appear to be effective immediately.
For more information regarding CMS Current Emergency response and issuances, use the link below:
Toyon’s Take on Hospital Charity Policies During the Emergency
As demand increases, providers should prepare for an influx of patients who are underinsured with high deductible health plans, or one of over 27 million Americans without health coverage. As hospitals care for these patients, it is important any corresponding patient discounts are specified in the patient financial assistance policy (FAP). If providers are loosening FAP requirements for care related to COVID-19 testing or treatment, it is recommended the FAP is updated to include this coverage. Specification in the FAP allows for uncompensated care cost recognition and payment for DSH providers.
Toyon is committed to keeping providers informed and will continue to send important updates as they unfold.


Toyon Associates, Inc.
Back to top
Toyon Associates Healthcare Finance


Receive a no obligation consultation on how Toyon can help make your cost reporting simpler, easier, and trusted.