Healthcare Providers Can Receive an Advance on Future Medicare Payments

On Saturday, March 28th, the Centers for Medicare & Medicaid Services (CMS) announced that it was expanding its pre-existing Accelerated and Advance Payment program. This program functionally offers a short-term business loan to eligible providers impacted by a natural disaster to accelerate their operational cash flow where their claims submissions and/or claims processing have been disrupted. In its current form, the program ensures that Medicare-participating healthcare providers will have access to expedited financial resources to continue operations while fighting the 2019 Novel Coronavirus (COVID-19) pandemic.

QUALIFICATIONS

In order to qualify, CMS requires applicants to apply for an advanced payment using an “Accelerated or Advance Payment Request Form” provided on each Medicare Administrative Contractor (MAC) website (monitor your MAC website for form updates). Medicare will start accepting and processing Accelerated and Advanced Payment requests immediately, given that the Provider meets the following qualifications:

1. Has billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s request form,
2. Is not in bankruptcy,
3. Is not be under active medical review or program integrity investigation, and
4. Does not have any outstanding delinquent Medicare overpayments.

PROCESS AND TIMELINE

In a fact sheet published along with the announcement, CMS noted that the expansion of this program is only for the duration of the COVID-19 public health emergency.

• Eligible providers can request up to 100% of the Medicare payments received for a “three-month period.”
• CMS anticipates issuing payments within seven calendar days.
• Medicare Part A and B providers will have 210 days from the date of the advanced payment to repay the balance.
• Provider claims submitted for ongoing patient care following receipt of the advanced payment will be applied toward the outstanding loan balance after 120 days. Each claim offsets a portion of the previously received advanced payment unless the provider has already paid the outstanding amount due in full.

We recommend healthcare providers seek the advice of counsel and/or financial advisers regarding the relevance of this advanced payment opportunity to your business. abeo client’s wishing to have help in accessing this program should please reach out directly to your client service manager or to Tim Ruse, VP Client Business Services, at tim.ruse@abeo.com or 469.277.3678.

abeo will continue to monitor legislative updates aimed at lessening the financial hardships of providers during the COVID-19 health emergency. We stand ready to assist you in any way we can.

Additional Resources:

• Find more information on the CMS Current Emergencies website
• BakerTilly.com, CMS Announces Accelerated and Advance Payment Program