Posted on Monday, March 30, 2020 3:39 PM
On Saturday, March 28, 2020, CMS activated the Accelerated and Advance Payment Program in order to assist healthcare providers with potential cash flow constraints. This means:
• a healthcare provider may request an advance payment from CMS
• the amount is based on the average total claims amount paid to the
provider during the prior months
• may but are not required to request the full amount; they may request a lower amount if desired
Eligibility
• Eligibility to request and receive the Advance Payment may be affected by bankruptcy, delinquent overpayments and/or being in an active medical review program or under a corporate program integrity investigation.
• CMS does not comment on whether having an active Corporate Integrity Agreement is an exclusion.
• Providers must have an idea of how much monthly is reimbursed to them in order to correctly request an amount equal to or below the monthly average.
Making the Request.
To request the Advance Payment from CMS, providers will need to:
Fact sheet: expansion of the accelerated and advance payments program for providers and suppliers during covid-19 emergency
• Complete the Medicare Administrative Contractor Request Form including the amount of advance payment requested
– The reason for the advance payment request should be indicated as National Emergency due to COVID-19
• Email or fax the signed request form and any necessary attachments (example: NGS is requesting a letter on organization letterhead)
Receiving the Payment
• Once the Medicare MAC has reviewed the request and determined a provider is eligible for the advance payment, the payment will be distributed to the provider.
• It is suspected that electronic payment will be made but details have not yet been released
• Timing of the payment may be as early as 7 days following payment request receipt, therefore it is critical that providers not delay submitting their request to their MAC due to the expected volume of requests that will be submitted.
Repayment
• Repayment period will begin at day 120 following disbursement of the Advance Payment
• Claims submitted for processing after day 120 will automatically be offset against the outstanding advance payment amount.
• Advance Payments must be repaid within 10 months, or 250 days following advance payment disbursement.
• Example:
– Provider requests $10,000 from Medicare as an advance payment on 4/1/2020 and payment of $10,000 is made to provider on 4/10/2020 by Medicare.
– Provider will continue submitting claims and claims will be reimbursed at the expected amount during the 120-day period following advance payment.
– At day 121 following advance payment, provider claims submitted to Medicare for reimbursement will be paid using an offset against the outstanding advance payment amount.
– At day 250 following advance payment, provider must have repaid their entire advance payment amount either by offset claim payments or by paying remaining balance due directly to Medicare.
Additional Information
National Government Services (NGS), Jurisdiction 6 and Jurisdiction K:
Home Health & Hospice MAC Jurisdictions
Corridor is Here to Help! We are available to assist with the Advance Payment program, including answering questions, providing best practice guidance on how to deposit, reconcile and monitor their balance owed on Advance Payments and remaining compliant with the terms of the program. Contact us at marketing@corridorgroup.com.
About Corridor
Corridor is the nation’s preferred partner and trusted business advisor to home health and hospice providers, providing quality services and impactful results for 30 years. Focusing on key operational, regulatory and financial challenges, Corridor delivering industry-unique solutions and deep expertise in coding, clinical documentation review, compliance, billing and collections , consulting and provider staff education . At Corridor, we make the business of caring for people Better! For the most important industry updates and news that impacts home health and hospice, please make sure to sign up for our weekly newsletter to receive the latest up-to-date industry information direct to your inbox!
For additional information, please contact Corridor at 1-866-263-3795.