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Accelerated and Advance Payments Offered to Medicare Participants Fighting COVID-19

04.15.2020

Centers for Medicare & Medicaid Services (CMS) recently announced that they’re expanding their current accelerated and advance payment program to help Medicare providers who are impacted by fighting COVID-19. The program offers advance funding and focuses on cash flow issues by providing payments based on historical performance, to be offset by future claims. This program helps ensure that Medicare providers have the funds they need in order to continue their fight against the current pandemic.

In order to be eligible, providers must:

  • Have billed Medicare for claims within 180 days immediately before the date of signature on the request form
  • Not be under active medical review or program integrity investigation
  • Not have outstanding delinquent Medicare overpayments
  • Cannot be in bankruptcy

To apply for the accelerated and advance payment program, complete the application available on each provider/supplier’s Medicare Administrative Contractor’s (MAC) website. Each MAC will work to review and issue payments within seven days of receiving the request. Providers and suppliers do not have administrative appeal rights related to initial payments. Click here to locate your designated MAC.

When completing the application(s):

  • Check box 2 (Delay in billing process of an isolated temporary nature beyond the normal billing cycle and not attributable to other third-party payers or private patients)
  • Request for accelerated payment due to ‘COVID-19 Pandemic’
  • Ensure form is completed to its entirety – incomplete forms will not be reviewed

Payment

Inpatient acute care hospitals, children’s hospitals and certain cancer hospitals

Can request up to 100% of the Medicare payment amount for a 6-month period

Critical access hospitals

Can request up to 125% of the Medicare payment amount for a 6-month period

Other providers (including skilled nursing homes)

Can request up to 100% of the Medicare payment amount for a 3-month period

Repayment is set to begin 120 days after the payment is issued. Non-hospital Part A providers and Part B suppliers will have 210 days from time of payment to repay the balance.

For local provider MAC’s:

  • Missouri – Excludes Durable Medical Equipment (DME), Home Health (HH) and Hospice as well as Wisconsin Physicians Service Insurance
  • Illinois – Excludes Durable Medical Equipment (DME), Home Health (HH) and Hospice as well as National Government Services

Please see the Accelerated and Advance Payments Fact Sheet for more details. For questions about the accelerated and advance payment programs, please contact Ron Present at 314.983.1358 or rpresent@bswllc.com, Tamika Mitchell at 314.824.5294 or tmitchell@bswllc.com or Mark Renken 636.754.0234 or mrenken@bswllc.com

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