Accelerated Payments and File Extensions for Medicare Providers Due to COVID-19

April 1, 2020 | Article

In order to assist in increasing cash flow for Medicare providers during the COVID-19 pandemic, the Center for Medicare and Medicaid Services (CMS) recently expanded the accelerated and advance payment program to a broad group of Medicare providers and suppliers.

How do you properly code COVID-19 related procedures?

How to Qualify for Advance/Accelerated Payments
In order to qualify for the advance/accelerated payments, the provider or supplier must:

  1. Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/supplier’s request form
  2. Not be in bankruptcy,
  3. Not be under active medical review or program integrity investigation, and
  4. Not have any outstanding delinquent Medicare overpayments

Eligible provider/suppliers can request a specific amount up to 100% of the Medicare payment amount for a three-month period. Inpatient acute care hospitals, children’s hospitals and certain cancer hospitals can request 100% of their Medicare payment up to a six-month period. Critical access hospitals can request up to 125% of their payment amount for a six-month period. Upon submission of the request, the Medicare Administrative Contractor (MAC) will review the request and they have indicated they should be able to issue payment within seven calendar days of receiving the request.

How to Submit Claims
You will be able to submit claims and receive payments as usual up until 120 days after the accelerated payment. After this time the recoupment process will start, and every claim submitted will be offset to repay this accelerated payment.

Instead of receiving your normal claim payment during this time, the payment will go to reduce your accelerated payment. The majority of hospitals will have up to one year from the date of the accelerated payment to repay the balance, while other provider/suppliers will have up to 210 days. At the end of this time if there is still a balance owed back to Medicare, the MAC will send a request for the remaining amount.

Extended Filing for Cost Reports
CMS, along with Medicare Administrative Contractors, has also granted due date extensions for Medicare Cost Reports due to the COVID-19 crisis. This extension is being granted to all providers and no further action is required to receive the extension.

Cost Report Ending Period Initial Due Date Extended Due Date
10/31/2019 3/31/2020 6/30/2020
11/30/2019 4/30/2020 6/30/2020
12/31/2019 5/31/2020 7/31/2020

Learn More about Relief Available
Healthcare organizations stand at the forefront of this pandemic and are in need of help to aid in the crisis. There are several relief options in play for organizations, including Medicare providers. In order to receive some of these measures, you’ll need to complete the necessary information and have the proper documentation.

Ensure you have the proper information ready for your accelerated payments.

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