In order to increase cash flow to health care providers and suppliers, the Centers for Medicare & Medicaid Services has expanded its current Accelerated and Advance Payment Program for the duration of the public health emergency.
To qualify for advance payments, the provider must have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’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.
Qualified providers must complete the Accelerated or Advance Payment Request form posted on their individual Medicare Administrative Contractor’s (MAC) website to receive payment, which will be issued within seven calendar days of receipt by the MAC.
Most providers and suppliers will be able to request up to 100% of their Medicare payment amount for a three-month period. Inpatient acute care hospitals, children’s hospitals, and certain cancer hospitals are able to request up to 100% of the Medicare payment amount for a six-month period. Critical access hospitals can request up to 125% of their payment amount for a six-month period.
Providers will receive full payment for claims submitted for 120 days after the date the advance payment is issued. At the end of the 120-day period, the recoupment process will begin and every claim submitted will be offset to repay the advance payment.
Inpatient acute care hospitals, children’s hospitals, certain cancer hospitals, and critical access hospitals have up to one year from the date the advance payment was made to repay the balance. All other Part A providers and Part B suppliers will have 210 days. At the end of the one year or 210 days, MACs will send a request for repayment of the remaining balance. The reconciliation process for Part A providers who receive Periodic Interim Payments (PIP) will occur 180 days after fiscal year end.
For more information, please contact our Albany office at (229) 883-7878 or our Atlanta office at (404) 220-8494.
Access all Client Alerts by clicking here.