Accelerated/Advance Payments Under the COVID-19 CARES Act CMS has expanded the current Accelerated and Advance Payment Program to a broader group of Medicare Part A providers and Part B suppliers.
CMS has expanded the current Accelerated and Advance Payment Program to a broader group of Medicare Part A providers and Part B suppliers.
The expansion of this program is only for the duration of the public health emergency.
CMS is authorized to provide accelerated or advance payments during the period of the public health emergency to any Medicare provider/supplier who submits a request to the appropriate Medicare Administrative Contractor (MAC) and meets the required qualifications.
Eligibility, Qualification and Process
To qualify the provider must:
- Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/supplier’s request form
- Not be in bankruptcy
- Not be under active medical review or program integrity investigation
- Not have any outstanding delinquent Medicare overpayments
Payment Amount
- Qualified providers are to request a specific amount using an Accelerated or Advance Payment Request form provided on each MAC’s website.
- Most providers and suppliers will be able to request up to 100% of the Medicare payment amount for a three-month period.
Processing Time
- Each MAC will review and issue payments within seven (7) calendar days of receiving the request.
Repayment
- CMS has extended the repayment of these accelerated/advance payments to begin 120 days after the date of issuance of the payment.
- Home health and hospice providers will have 210 days from the date of the accelerated or advance payment was made to repay the balance.
Recoupment and Reconciliation
- Providers can continue to submit claims as usual after the issuance of the accelerated or advance payment; however, recoupment will not begin for 120 days.
- Providers will receive full payments for their claims during the 120-day delay period.
- At the end of the 120-day period, the recoupment process will begin, and every claim submitted by the provider/supplier will be offset from the new claims to repay the accelerated/advanced payment.
- Instead of receiving payment for newly submitted claims, the provider’s/supplier’s outstanding accelerated/advance payment balance is reduced by the claim payment amount. This process is automatic.
