April 26, 2020
CMS Re-Evaluates Accelerated Payment Program and Suspends Advance Payment Program
April 26, 2020—The Centers for Medicare & Medicaid Services (CMS) announced that it is re-evaluating the amounts that will be paid under its Accelerated Payment program. Additionally, CMS is suspending its Advance Payment program to Part B suppliers effective immediately. CMS noted that the announcement comes after the payment of more than $100 billion to health care providers and suppliers through these programs and in light of the $175 billion recently appropriated for health care provider relief payments.
According to the announcement, CMS had expanded these temporary loan programs to ensure that providers and suppliers had the resources needed to combat the beginning stages of the COVID-19 pandemic. Funding will continue to be available to hospitals and other health care providers on the front lines of the coronavirus response, primarily from the Provider Relief Fund.
CMS advised that the Accelerated and Advance Payment (AAP) programs are typically used to give providers emergency funding and address cash flow issues for providers and suppliers when there is disruption in claims submission or claims processing, including during a public health emergency or a President-declared disaster.
Since expanding the AAP programs on March 28, 2020, CMS approved more than 21,000 applications, totaling $59.6 billion in payments to Part A providers, which includes hospitals. For Part B suppliers, including doctors, nonphysician practitioners, and durable medical equipment suppliers, CMS approved almost 24,000 applications, advancing $40.4 billion in payments. The AAP programs are not a grant, and providers and suppliers are typically required to pay back the funding within 1 year, or less, depending on provider or supplier type, advised CMS.
Beginning immediately, CMS will not be accepting any new applications for the Advance Payment program, and CMS will be re-evaluating all pending and new applications for Accelerated Payments in light of historical direct payments made available through the Department of Health & Human Services’ (HHS) Provider Relief Fund.
Significant additional funding will continue to be available to hospitals and other health care providers through other programs. Congress appropriated $100 billion in the Coronavirus Aid, Relief, and Economic Security (CARES) Act (PL 116-136) and $75 billion through the Paycheck Protection Program and Health Care Enhancement Act (PL 116-139) for health care providers. HHS is distributing this money through the Provider Relief Fund. These payments do not need to be repaid.
Finally, CMS stated that the CARES Act Provider Relief Fund is being administered through HHS and has released $30 billion to providers. It is in the process of releasing an additional $20 billion, with more funding anticipated to be released soon. This funding will be used to support health care–related expenses or lost revenue attributable to the COVID-19 pandemic and to ensure uninsured Americans can get treatment for COVID-19.