March 28, 2020
Area(s) of Interest: Payor Issues and Reimbursement Public Health
The Centers for Medicare & Medicaid Services (CMS) on Saturday announced an expansion of its accelerated and advance payment program for participating Medicare providers and suppliers.
This expansion is intended to lessen the financial hardships of providers facing extraordinary challenges related to the COVID-19 pandemic, which is causing significant disruption to the health care industry, and ensures the nation’s providers can focus on patient care.
Accelerated and advance Medicare payments provide emergency funding and address cash flow issues based on historical payments when there is disruption in claims submission and/or claims processing. These expedited payments are typically offered in natural disasters to accelerate cash flow to the impacted health care providers and suppliers.
CMS is expanding the program to all Medicare providers and supplier throughout the country for the duration of the public health emergency related to COVID-19. The payments can be requested by hospitals, doctors, durable medical equipment suppliers and other Medicare Part A and Part B providers and suppliers.
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.
Medicare will start accepting and processing the Accelerated/Advance Payment Requests immediately. California physicians should submit a request to Noridian, California's Medicare contractor. Physicians can request 100% of their historical Medicare payment amount for a three-month period. CMS anticipates that the payments will be issued within seven days of the provider’s request. Repayment of the advance payments begin 120 days after the issuance of the advance payment. Physicians have 210 days from the issuance of the advance payment to repay the entire balance due to CMS.
Noridian has also scheduled a number of webinars to assist providers with the process of submitting advance payment requests.
For more information, see the CMS fact sheet on the accelerated/advance payment process.