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Tag: Medicare

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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CARES Act Funding Attestation – Action Required

Providers receiving relief payments from the CARES Act funding are required to confirm receipt and agree to the terms and conditions within 30 days of payment. Providers are to submit their attestation using the CARES Act Provider Relief Fund Payment Attestation Portal, available here.

Providers have 30 days to attest after receipt of CARES Act funding and will need to provide the following information:

  • Billing Tax ID Number(s).
  • Last six digits of deposit bank account number.
  • Amount of relief payment..

Per HHS’s terms and conditions, these are the significant items:

  • Submit a report within 10 days after each calendar quarter regarding the use of the funds (details of the report have not been released).
  • Agree to not balance bill any patient for out-of-network services (i.e., the amount above if in-network) during the public health emergency period.

The third and fourth terms of HHS’s terms and conditions state:

The Recipient certifies that the Payment will only be used to prevent, prepare for, and respond to coronavirus, and shall reimburse the Recipient only for health care related expenses or lost revenues that are attributable to coronavirus. The Recipient certifies that it will not use the Payment to reimburse expenses or losses that have been reimbursed from other sources or that other sources are obligated to reimburse.”

Toyon’s Take
While relief funding will not likely make healthcare providers whole for the losses attributed to the impact of COVID-19, it is recommended providers identify and delineate items reimbursed in current and future legislation during the emergency period. Some examples include: 

  • Payroll Protection Program
  • FEMA assistance
  • Any additional funds for unreimbursed COVID-19 expenses
  • Reimbursement for the uninsured (i.e., Medicare DSH Uncompensated Care)

Please contact Robert Howey at robert.howey@toyonassociates.com or 888.514.9312 with any questions.

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CARES Act Funding – Next Round of $50 BILLION and Eligibility

 Funding Eligibility Deadline is Before Midnight PT Thursday, April 23.

 

Next Round of $50 billion in CARES Act Funding – Action Required 

HHS is preparing to release the next round of relief from the CARES Act funding. For payment eligibility, particularly related to HHS’s $10 billion targeted distribution, hospitals are to provide HHS the following information:

  1. Total number of Intensive Care Unit beds as of April 10, 2020
  2. Total number of admissions with a positive diagnosis for COVID-19 from January 1, 2020 to April 10, 2020
  3. National Provider Identifier(s)
  4. Tax Identification Number(s)

This round of CARES Act funding includes:

  • $20 billion general allocation based on 2018 net patient revenue. HHS will begin disbursing weekly payments to “Medicare facilities and providers” starting April 24.
  • $10 billion targeted allocation to hospitals in areas excessively impacted by COVID-19. Hospitals should apply for a portion of these funds by providing four data points as stated above.
  • $10 billion allocation for rural providers. Funds will be distributed using operating expenses to allocate amounts to each provider as early as the week of April 27.
  • $400 million allocation for Indian Health Services

Funds will be distributed using operating expenses to allocate amounts to each provider as early as the week of April 27. 

HHS e-mailed this one page document to your organization’s site administrator with additional information. For clarification on who within your organization received this notification, or if you have questions about the registration process, please contact TeleTracking Technical Support at 877-570-6903.

Uninsured COVID-19 Reimbursement

Every provider treating uninsured COVID-19 patients on or after February 4, 2020, can request claims reimbursement through this Program and will be reimbursed at Medicare rates, subject to available funding. On April 27, 2020, providers can register for this Program and begin submitting claims in early May 2020.

Please contact Robert Howey at robert.howey@toyonassociates.com or 888.514.9312 with any questions.

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