UPDATE: CMS reevaluates Accelerated Payment Program, suspends Advance Payment Program for Part B suppliers and points providers to relief fund

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On April 26, 2020, the Centers for Medicare & Medicaid Services (CMS) announced that it is reevaluating pending and future amounts that it will pay under its Accelerated Payment Program and is suspending its Advance Payment Program for Part B suppliers, effective immediately. CMS noted it has already approved almost 24,000 applications resulting in $40.4 billion of payments for Part B suppliers, including doctors, non-physician practitioners and durable medical equipment suppliers.  

Please note: This is an abrupt change, as CMS has been promoting the Accelerated and Advanced Payment Program (AAP) as a tool for providers suffering financially for the duration of the COVID-19 emergency period. 

The AAP Program is used to give financial assistance to providers and suppliers during a natural disaster, but also applies to public health emergencies. In a previous alert, we discussed how CMS has expanded these temporary payment programs to ensure providers and suppliers had the resources needed to fight the coronavirus (COVID-19) due to the prospect of anticipated losses in revenue. The AAP programs are not a grant, but require providers and suppliers to pay back the funding within one year, with the repayment timeline depending on the provider or supplier type.

CMS stated that funding will continue to be available to hospitals and other healthcare providers primarily through the Provider Relief Fund. The Provider Relief Fund totals $175 billion through the Coronavirus Aid, Relief, and Economic Security (CARES) Act and recently passed Paycheck Protection Program and Health Care Enhancement Act.

While these Provider Relief Fund payments do not need to be repaid, the initial disbursements require providers to certify to certain terms and conditions within 30 days or they must return the funds to the Department of Health and Human Services (HHS). HHS has already made $50 billion in direct automatic payments to providers and $20 billion in additional funding is projected to soon be released for high priority hospitals and rural hospitals as determined by HHS.

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