CMS Expands AAPP to Fast-Track Payments for Providers + Suppliers
April 8, 2020
- CMS has expanded its Accelerated/Advance Payment Program by $34B for providers and suppliers.
- Most providers and suppliers will be able to request up to 100% of the Medicare payment amount for a three-month period.
- The goal is to review + facilitate payments by Medicare Administrative Contractors within 7 days of receipt.
The Centers for Medicare and Medicaid Services (CMS) has announced an expansion of its Advance Payments Program for Medicare providers and suppliers during the COVID-19 emergency. The Program is designed to offer relief to providers by accelerating payments and expediting cash flow.
To qualify for advance/accelerated payments, a provider or supplier must satisfy four requirements. 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.
Qualified providers/suppliers will be asked to request a specific amount using the Accelerated and Advance Payments Request form provided on the relevant Medicare Administrative Contractor’s (MAC) website. Most providers and suppliers will be able to request up to 100% of the 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, and critical access hospitals can request up to 125% of their payment amount for a six-month period. Each MAC will work to review and issue payments within seven calendar days of receiving the request.
Although different time periods will apply for the special providers noted above, most providers will follow this process:
- Providers and suppliers receive their advance payment, which is based on the average payments during the relevant prior period.
- During the next 120 days, providers and suppliers may continue to submit claims for which they will be paid.
- After 120 days, the reconciliation and recoupment process will begin, during which the providers/suppliers will not receive payment for new claims, but will instead see the new claims offset and reduce the advance payment balance.
A CMS Fact Sheet explaining the process and how to apply for payments can be downloaded here.
Ralph Breitfeller is of counsel with Kegler Brown, where he represents health care suppliers and providers before numerous federal and state regulatory bodies and in Medicaid audits and fraud investigations.
Ralph can be reached at [email protected] or (614) 462-5427.