Medicare will accelerate payments to providers and suppliers, CMS announces

Healthcare providers and suppliers throughout the country can start receiving accelerated and advance payments from the Medicare program to offer emergency funding and address cash flow issues caused by COVID-19 disruptions.

Over the weekend, the Centers for Medicare & Medicaid Services (CMS) announced it is expanding its accelerated and advance payment program for Medicare (PDF) providers based on historical payments when there is a disruption in claims submission and/or claims processing to ensure they have the resources to fight COVID-19. 

The expedited payments are typically offered in natural disasters to accelerate cash flow to the impacted healthcare providers and suppliers, officials said. But, in this situation, CMS is expanding the program for all Medicare providers throughout the country. The payments can be requested by hospitals, doctors, durable medical equipment suppliers and other Medicare Part A and Part B providers and suppliers.

The expansion comes as the industry has seen great disruption, with providers being asked to delay revenue-generating but nonessential surgeries and procedures even as healthcare staff are unable to work due to childcare demands, billing has been disrupted and expenses have risen.

RELATED: Analysis: COVID-19 could raise Medicare spending by as much as $115B over next year

“With our nation’s health care providers on the front lines in the fight against COVID-19, dollars and cents shouldn’t be adding to their worries,” said CMS Administrator Seema Verma in a statement. “Unfortunately, the major disruptions to the healthcare system caused by COVID-19 are a significant financial burden on providers. Today’s action will ensure that they have the resources they need to maintain their all-important focus on patient care during the pandemic.” 

It's among a number of areas of regulatory relief CMS has extended in recent days as providers face the growing tide of COVID-19 patients. For instance, the Trump administration extended the deadlines for quality reporting and applications for providers in value-based care programs and announced it will not use any quality data on services from Jan. 1 through June 30 in the agency’s calculations for quality reporting and value-based purchasing programs.

To qualify for accelerated or advance payments, 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
  • Not have any outstanding delinquent Medicare overpayments

RELATED: CMS lays out regulatory relief for value-based care programs amid COVID-19 pandemic

Most providers and suppliers will be able to request up to 100% of the Medicare payment amount for a three-month period, officials said. 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 while critical access hospitals can request up to 125% of their payment amount for a six-month period. 

The majority of hospitals will have up to one year from the date the accelerated payment was made to repay the balance.

Officials said Medicare will start accepting and processing the accelerated/advance payment requests immediately and anticipate the payments will be issued within seven days of the provider’s request.