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CMS Provides Financial Relief for Medicare Providers

3/30/20 – Dave Macke

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On March 28, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a release announcing an expansion of its accelerated program for Medicare participating health care providers and suppliers. CMS recognizes that providers need resources to combat the coronavirus. They hope to loosen the financial hardship that many providers are now facing.

To qualify for accelerated or advance payments, the provider or supplier 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, and
  • Not have any outstanding delinquent Medicare overpayments.

The amount of the payment providers can request will be up to 100% of the Medicare payment amount for a three-month period. Critical Access Hospitals can request up to 125%. The processing should be within seven (7) days of the MAC receives the request. 

Repayment begins 120 days after the date of issuance of the payment. Inpatient acute care hospitals and Critical Access Hospitals have up to one year to repay the balance. All other Part A and Part B providers must repay the balance within 210 days from the date of the payment.

The recoupment process will begin after the 120 day period, and every claim that is submitted by the Provider / Supplier will be offset from the new claims to repay the advance payment. Therefore, instead of receiving a payment for newly submitted claims, the outstanding balance is reduced by the claim payment amount. This process is automatic.

An informational fact sheet on the accelerated/advance payment process and guidelines on how to submit a request can be found here: www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-Sheet.pdf

In addition, you will need to complete a Request for Accelerated / Advance Payment Form and submit to the MAC. Following are links to the form on the Palmetto GBA and CGS websites.

Palmetto GBA

https://palmettogba.com/palmetto/Mforms.nsf/files/FN-HHH-A-2005.pdf/$File/FN-HHH-A-2005.pdf?Open&

CGS Administrators

https://cgsmedicare.com/pdf/accelerated_req_form.pdf

For assistance applying for an Accelerated / Advance Payment, or for any questions related to Medicare and Medicaid services, please contact Dave Macke at
859-957-1421 or dmacke@vlcpa.com.