CMS accelerates advance payments for Medicare providers and suppliers to combat COVID-19

On March 28, the Centers for Medicare & Medicaid Services (CMS) announced an expansion of its accelerated and advance payment program for Medicare participating health care providers and suppliers, to ensure they have the resources needed to combat COVID-19. This program expansion, which includes changes from the recently enacted Coronavirus Aid, Relief, and Economic Security (CARES) Act, is only for the duration of the public health emergency to minimize financial hardship caused by the disruption in claims submission or claims processing.

Accelerated/Advance payments can be requested by hospitals, doctors, durable medical equipment suppliers and other Medicare Part A and Part B providers. According to CMS, most providers and suppliers will be able to request up to 100 percent of their Medicare reimbursement amount for a three-month period.

To qualify for advance/accelerated payments, providers and suppliers must meet the following requirements:

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.

Medicare will start accepting and processing the accelerated/advance payment requests immediately, and anticipates that the payments will be issued within seven days from receipt of the request. After 120 days from the date the accelerated payment is received, an automatic recoupment process will begin, and providers and suppliers will have 210 days to repay the balance. Instead of paying newly submitted claims in full, Medicare payment amounts will be automatically reduced to repay the outstanding accelerated/advance payment balance.

Providers and suppliers with outstanding delinquent Medicare overpayments are also not allowed to ask for advance payment.

Providers and suppliers must contact the Medicare Administrative Contractor (MAC) that serves their geographic area to complete an Accelerated/Advance Payment Request form via mail or email. CMS has established COVID-19 hotlines at each MAC that are operational Monday – Friday to assist with accelerated payment requests. To locate your designated MAC, refer to https://www.cms.gov/Medicare/Medicare-Contracting/Medicare-Administrative-Contractors/Downloads/MACs-by-State-June-2019.pdf.

For more information about the Accelerated/Advance Payment Program, see the CMS fact sheet here: www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-Sheet.pdf