CMS reevaluates Accelerated Payment Program and Suspends Advance Payment Program

The Centers for Medicare & Medicaid Services April 26 announced it is reevaluating the amounts that will be paid under its Accelerated Payment Program and suspending its Advance Payment Program effective immediately. In late March, CMS had expanded the programs to all Medicare providers and suppliers meeting certain eligibility criteria. The programs are intended to provide necessary funds to providers when there is a disruption in claims submission and/or claims processing. The funds will be recouped by CMS after a certain timeframe, depending on the provider or supplier type.

The agency reports that the programs have thus far provided more than $100 billion to providers and suppliers during the COVID-19 public health emergency. Specifically, CMS approved more than 21,000 applications totaling $59.6 billion in payments to Part A providers, including hospitals. CMS approved almost 24,000 applications totaling $40.4 billion in payments for Part B suppliers, including doctors and other practitioners.

Beginning April 26, CMS will not accept any new applications for the Advance Payment Program, and the agency will be reevaluating all pending and new applications for Accelerated Payments. CMS has previously referred to “accelerated” payments in reference to inpatient prospective payment system hospitals, children’s hospitals, cancer hospitals and critical access hospitals and “advance” payments in reference to all other providers and suppliers. CMS states that the reevaluation is in light of the payments made through the Provider Relief Fund distributed by the Department of Health and Human Services.

The AHA had previously urged the agency to make a number of improvements to the accelerated and advance payment programs, including more flexible repayment terms and elimination or substantial reduction in the interest rate. The AHA and other groups last week again urged HHS and CMS to improve the programs.

AHA members earlier today received a Special Bulletin on the issue.