Family physicians racing to quell the COVID-19 pandemic can expect a significant payment boost from CMS, thanks to the Academy's advocacy.
On March 28, the agency announced(www.cms.gov) an expansion of its accelerated and advance payment program to help Medicare participants fight COVID-19. The program provides emergency funding and addresses cash-flow issues during emergencies by delivering payments based on historic performance, to be offset by future claims.
The AAFP asked for such a move in a March 26 letter to CMS,(3 page PDF) which the Academy signed along with eight other medical and health organizations, that called for swift adjustments in payment policy.
"We recognize that CMS' view is generally that policy and procedures on advance and
accelerated payments are made with the expectation that bills will be used to offset the
advance payments, not to compensate hospitals for lost revenues due to a decrease in nonemergent services," the AAFP said.
"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," CMS Administrator Seema Verma, M.P.H., said in a statement announcing the new policy. "Today's action will ensure that they have the resources they need to maintain their all-important focus on patient care during the pandemic."
Medicare will start accepting and processing payment requests immediately, the statement said, and checks will be issued within seven days of the request. Hospitals, physicians, durable medical equipment suppliers and other Medicare Part A and Part B providers and suppliers are eligible to apply;(www.cms.gov) most will be able to request up to 100% of the Medicare payment amount for a three-month period.
To qualify for accelerated or advance payments, a practice must
- have billed Medicare for claims within 180 days immediately before the date of signature on the request form,
- not be in bankruptcy,
- not be under active medical review or program integrity investigation, and
- not have any outstanding delinquent Medicare overpayments.
Repayment is set to begin 120 days after the payment is issued. Nonhospital Part A and Part B health care providers will have 210 days from the payment date to repay the balance.
The Academy and its co-signatories also asked HHS to immediately begin making periodic interim payments to physicians, a proposal that CMS later addressed.
"For the small subset of Part A providers who receive Period Interim Payment, the accelerated payment reconciliation process will happen at the final cost report process (180 days after the fiscal year closes)," CMS' March 28 statement said.
Related AAFP News Coverage
AAFP to Host Weekly COVID-19 Virtual Town Halls
Tune in Each Wednesday at 7 p.m. CDT
More From AAFP
In the Trenches: COVID-19: The AAFP Is Working to Keep You Informed, Prepared