CMS Expands Accelerated and Advance Payments Program during COVID-19 Emergency

Any eligible Medicare provider or supplier who submits a request to its Medicare Administrative Contractor is qualified to receive advance/accelerated payments from CMS. To be eligible, the provider/supplier must have billed Medicare for claims within the past 180 days (prior to the date on the request form), not be in bankruptcy or have any outstanding delinquent Medicare overpayments and not be under an active medical review or program integrity investigation.

Qualified providers and suppliers will be asked to specify the amount they are requesting. Most providers are able to request up to 100% of their Medicare payment for a three-month period, with inpatient acute care, children's and cancer hospitals able to request 100% of their Medicare payment for six months. Critical access hospitals may request 125% of their payment amount for a six-month period. Repayment will begin 120 days after the payment is issued with hospitals having up to one year from the date the payment was made to repay the balance and all other Part A providers and Part B suppliers having 210 days. During the 120-day grace period, full payment will be made on claims submitted by providers and suppliers. Thereafter, CMS will begin to recoup the advance payment by automatically offsetting this amount against Medicare claims submitted by the provider or supplier. After one year for hospitals or 210 days for all other providers and suppliers, reconciliation will be performed and any remaining balance will be collected by the MAC by direct payment.

The request form for Indiana providers and suppliers may be found on the Wisconsin Physician Services' (WPS) website at https://www.wpsgha.com/wps/portal/mac/site/fees-and-reimbursements/forms/accelerated-payment-request-certification-covid-19 with the completed form emailed to AccAdvPymtReq@wpsic.com. The request form for Illinois providers and suppliers is available here. Ohio providers and suppliers can find the request form on the CGS Administrators' website at https://www.cgsmedicare.com/parta/topic/covid-19 and completed forms may be emailed to CGS at CGS.ERS.CORR@cgsadmin.com or faxed to 1.615.664.5949. Ohio providers and suppliers should be aware that CGS has specific instructions regarding the request form that can be found on the above referenced webpage.

If you should have any additional questions, please contact Taryn Stone at Taryn.Stone@icemiller.com or Margaret Emmert at Margaret.Emmert@icemiller.com.

This publication is intended for general information purposes only and does not and is not intended to constitute legal advice. The reader should consult with legal counsel to determine how laws or decisions discussed herein apply to the reader’s specific circumstances.