Healthcare Client Alert

    By Laura Dickson Rixey, Health Care

    Apply for 3 Months of Advanced Medicare Payments

    The Centers for Medicare & Medicaid Services (CMS) announced an expansion of its accelerated and advance payment program for certain Medicare participating providers and suppliers to ensure they have the financial resources they need during the COVID-19 crisis. Under this program, CMS will provide an approved applicant with up to 100% of the applicant’s Medicare payment amount for a 3-month period (this amount is even more for certain hospitals).  The payments can be requested by hospitals, doctors, DME suppliers and other Medicare Part A and Part B providers and suppliers.  

    To qualify for an accelerated or advance payment, the applicant must:

    • Have billed Medicare for claims within 180 days immediately prior to the date of the application.
    • Not be in bankruptcy.
    • Not be under active medical review or program integrity investigation; and
    • Not have any outstanding delinquent Medicare overpayments. 

    CMS is processing applications immediately, with payments expected to be issued within seven (7) days of the provider’s application being submitted (which can be done via email or mail). Applications are completed for each billing PTAN/NPI combination—each rendering physician does not need to request payment. To submit one request for multiple PTAN/NPI combinations within a private practice, CMS has advised practices to submit a spreadsheet with all of the PTAN/NPIs included.

    For nearly all providers other than hospitals, repayment of the amount advanced will automatically begin 120 days after the issuance of the accelerated/advance payment. Payment will be applied automatically through recoupment as actual Medicare claims are processed and paid—but only beginning 120 days after the issuance of the payment. Claims will continue to be processed and paid during that 120 day window, but they will not be subject to recoupment until after it passes. Providers can alternatively submit repayment via check at any time. 

    Providers in Virginia must apply through Palmetto GBA by completing the applicable form on the Palmetto GBA website, available here. The application for Part B Medicare providers in Virginia (FN-JJ-B-2005), is available here.

    Palmetto GBA posted Frequently Asked Questions and Answers on its website on March 31st, available here. These are very useful and are being constantly updated.

    Finally, CMS has posted a wonderful summary of the program in a short fact sheet, available here.

    Please do not hesitate to reach out to us with any questions about applying for these Medicare advance payments or any other concerns you have. Our firm is here to help you through this crisis. 

    The contents of this publication are intended for general information only and should not be construed as legal advice or a legal opinion on specific facts and circumstances. Copyright 2024.