COVID-19 Financial Assistance - Medicare Accelerated Payments Application & FAQ

In order to increase cash flow to providers of services and suppliers impacted by the 2019 Novel Coronavirus (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) has expanded our current Accelerated and Advance Payment Program to a broader group of Medicare Part A providers and Part B suppliers. The expansion of this program is only for the duration of the public health emergency. Details on the eligibility, and the request process are outlined below. The information below reflects the passage of the CARES Act (P.L. 116-136).

FACT SHEET:
EXPANSION OF THE ACCELERATED AND ADVANCE PAYMENTS PROGRAM FOR PROVIDERS AND SUPPLIERS DURING COVID-19 EMERGENCY

Accelerated/Advance Payments

An accelerated/advance payment is a payment intended to provide necessary funds when there is a disruption in claims submission and/or claims processing. These expedited payments can also be offered in circumstances such as national emergencies, or natural disasters in order to accelerate cash flow to the impacted health care providers and suppliers. CMS is authorized to provide accelerated or advance payments during the period of the public health emergency to any Medicare provider/supplier who submits a request to the appropriate Medicare Administrative Contractor (MAC) and meets the required qualifications.

Request for Accelerated/Advance Payment Form

Eligibility & Process

  • Eligibility: To qualify for advance/accelerated payments the provider/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.
  • Amount of Payment: Qualified providers/suppliers will be asked to request a specific amount using an Accelerated or Advance Payment Request form provided on each MAC’s website. Most providers and suppliers will be able to request up to 100% of the Medicare payment amount for a three-month period. 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. Critical access hospitals (CAH) can request up to 125% of their payment amount for a six-month period.
  • Processing Time: Each MAC will work to review and issue payments within seven (7) calendar days of receiving the request.

  • Repayment: CMS has extended the repayment of these accelerated/advance payments to begin 120 days after the date of issuance of the payment. The repayment timeline is broken out by provider type below:

    • Inpatient acute care hospitals, children’s hospitals, certain cancer hospitals, and Critical Access Hospitals (CAH) have up to one year from the date the accelerated payment was made to repay the balance.
    • All other Part A providers and Part B suppliers will have 210 days from the date of the accelerated or advance payment was made to repay the balance.

The payments will be recovered according to the process described in number 7 below.

  • Recoupment and Reconciliation:

    • The provider/supplier can continue to submit claims as usual after the issuance of the accelerated or advance payment; however, recoupment will not begin for 120 days. Providers/ suppliers will receive full payments for their claims during the 120-day delay period.  At the end of the 120-day period, the recoupment process will begin and every claim submitted by the provider/supplier will be offset from the new claims to repay the accelerated/advanced payment. Thus, instead of receiving payment for newly submitted claims, the provider’s/supplier’s outstanding accelerated/advance payment balance is reduced by the claim payment amount. This process is automatic.
    • The majority of hospitals including inpatient acute care hospitals, children’s hospitals, certain cancer hospitals, and critical access hospitals will have up to one year from the date the accelerated payment was made to repay the balance. That means after one year from the accelerated payment, the MACs will perform a manual check to determine if there is a balance remaining, and if so, the MACs will send a request for repayment of the remaining balance, which is collected by direct payment. All other Part A providers not listed above and Part B suppliers will have up to 210 days for the reconciliation process to begin.
    • For the small subset of Part A providers who receive Period Interim Payment (PIP), the accelerated payment reconciliation process will happen at the final cost report process (180 days after the fiscal year closes).

A step by step application guide can be found below. More information on this process will also be available on your MAC’s website.

Step-by-Step Guide on How to Request Accelerated or Advance Payment

  1. Complete and submit a request form: Accelerated/Advance Payment Request forms vary by contractor and can be found on each individual MAC’s website.  Complete an Accelerated/ Advance Payment Request form and submit it to your servicing MAC via mail or email.  CMS has established COVID-19 hotlines at each MAC that are operational Monday – Friday to assist you with accelerated payment requests. You can contact the MAC that services your geographic area. To locate your designated MAC, refer to https://www.cms.gov/Medicare/Medicare-Contracting/Medicare-AdministrativeContractors/Downloads/MACs-by-State-June-2019.pdf.

    • National Government Services (NGS) - Jurisdiction 6 & Jurisdiction K (CT, IL, ME, MA, MN, NY, NH, RI, VT, WI, and home health and hospice claims for the following states: AK, AS, AZ, CA, CT, GU, HI, ID, MA, ME, MI, MN, NH, NV, NJ, NY, MP, OR, PR, RI, US VI, VT, WI, and WA).   The toll-free Hotline Telephone Number: 1-888-802-3898 Hours of Operation: 8:00 am – 4:00 pm CT

  2. What to include in the request form: Incomplete forms cannot be reviewed or processed, so it is vital that all required information is included with the initial submission. The provider/ supplier must complete the entire form, including the following:

    • Provider/supplier identification information:

      • Legal Business Name/ Legal Name;
      • Correspondence Address;
      • National Provider Identifier (NPI);
      • Other information as required by the MAC.

    • Amount requested based on your need:

      • Most providers and suppliers will be able to request up to 100% of the Medicare payment amount for a three-month period. However, 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. Critical access hospitals (CAH) can now request up to 125% of their payment amount for a six-month period.

    • Reason for request:

      • Please check box 2 (“Delay in provider/supplier billing process of  an isolated temporary nature beyond the provider’s/supplier’s normal billing cycle and not attributable to other third party payers or private patients.”); and
      • State that the request is for an accelerated/advance payment due to the COVID19 pandemic.

  3. Who must sign the request form? The form must be signed by an authorized representative of the provider/supplier.

  4. How to submit the request form: While electronic submission will significantly reduce the processing time, requests can be submitted to the appropriate MAC by fax, email, or mail. You can also contact the MAC provider/supplier helplines listed above.

  5. What review does the MAC perform? Requests for accelerated/advance payments will be reviewed by the provider or supplier’s servicing MAC. The MAC will perform a validation of the following eligibility criteria:

    • Has billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s or supplier’s request form,
    • Is not in bankruptcy,
    • Is not under active medical review or program integrity investigation,
    • Does not have any outstanding delinquent Medicare overpayments.

  6. When should you expect payment? The MAC will notify the provider/supplier as to whether the request is approved or denied via email or mail (based on   the provider’s/supplier’s preference). If the request is approved, the payment will be issued by the MAC within 7 calendar days from the request.

  7. When will the provider/supplier be required to begin repayment of the accelerated/ advanced payments? Accelerated/advance payments will be recovered from the receiving provider or supplier by one of two methods:

    • For the small subset of Part A providers who receive Period Interim Payment (PIP), the accelerated payment will be included in the reconciliation and settlement of the final cost report.
    • All other providers and suppliers will begin repayment of the accelerated/advance payment 120 calendar days after payment is issued.

  8. Do provider/suppliers have any appeal rights? Providers/suppliers do not have administrative appeal rights related to these payments. However, administrative appeal rights would apply to the extent CMS issued overpayment determinations to recover any unpaid balances on accelerated or advance payments.

Accelerated or Advanced Payment Process Frequently Asked Questions and Resources If you have questions about the accelerated and advance payment process, you may call the National Government Services Hotline at 888-802-3898 for assistance. Representatives are available Monday through Friday for JK providers from 8:00 a.m.–4:00 p.m. ET and for J6 providers from 8:00 a.m.–4:00 p.m. CT.Frequently Asked Questions

  • Do we submit the form for the rendering or billing NPI/PTAN?
    You must use the billing NPI/PTAN. We have to return/reject requests if you use the rendering provider information instead of the billing provider information. You must submit the form the same way you bill us (e.g., if you bill us by the group, you must submit the request for the group).

  • What address should we enter on the form? Billing or physical?
    You should use the physical address.

  • Do I have to submit a separate request for each NPI/PTAN?
    Providers that are part of a group practice may attach a list of NPI/PTANs to the form. The authorized representative must have authority to sign on behalf of all parties included in the list.

    NGS prefers that the requests for Part A accelerated payments be submitted in aggregate for all of Part A units. Each subunit does not need its own request form. For example, a hospital that has psych and rehab subunits can submit one form for all three providers. However, they should notate this on their form. Also, inpatient and outpatient for a Part A provider should be combined in one request. 

  • Who can sign the accelerated/advance payment requests?  
    The form must be signed by the provider’s authorized official that is legally able to make financial commitments and assume financial obligations on behalf of the provider. It must be the person identified in PECOS as the authorized/delegated official.

  • Is letterhead required with emails?
    No, we don’t require the letterhead when you submit your request via email. The email/form should say that the request is due to COVID-19.  

  • Can I use a digital signature?
    Digital signatures are acceptable on the form. Chrome users will need to download and save the form to activate the digital signature feature.

  • If a provider is getting another federal loan such as the paycheck protection program are they still eligible for the advance/accelerated payment?
    Yes, these are completely separate. 

  • What are the requirements to be eligible for an advance/accelerated payment?
    Requirements/eligibility:

    • The provider has billed claims during the 180 days prior to the effects of COVID-19.
    • The provider is not under a fraud investigation. The MAC will perform program integrity checks.  CMS considers a provider to have met the eligibility requirement of not being under an active program integrity investigation when the provider is not:
      • Currently under investigations, audits and/or reviews which indicate findings of potential fraudulent activity; and/or under active law enforcement investigation.
      • This includes providers on targeted probe and educate.
      • The MAC may need to confirm fraud information with the Unified Program Integrity Contractor in the event that the MAC identifies any current and/or previous fraud-related investigations, audits or reviews in the Unified Case Management related to
      • The provider is currently not in an active bankruptcy status (not settled) or indicates/plans to file bankruptcy.
      • The provider has no delinquent debts that have not been paid for over 120 days.

  • What is the status of my request?
    Due to overwhelming provider response to the accelerated/advanced payment requests, we are processing requests as expediently as possible. We are processing in the order that requests are received. When payments are processed, you will receive a response to your email regarding the payment amount. We are reaching out directly to any providers that have incomplete submissions and/or if we have any questions needed to process the payment request.  

  • What do I do if I submitted the form with an incorrect amount request? How do I correct it?
    You will submit a corrected form indicating the date the original form was submitted and explaining why you are submitting this corrected form.

  • When is the last day to apply for the advanced/accelerated payment?
    No date has been given as to when requests have to be submitted by.

  • Is this being offered by the Medicare Advantage plans?
    Providers will need to contact the MA plan(s).

  • Why did I get less than I requested?
    CMS provides us with a total eligible dollar amount based on the providers billing history just prior to COVID-19.  Most providers are eligible up to 100% of that amount, critical access hospitals are eligible up to 125%. If you ask for more than you are eligible for, we grant the full amount that you are eligible for. 

  • Where does it state in writing that the provider will be charged interest on the unpaid balance remaining? 
    Our website has a section that discusses responding to a demand letter (Part A, HH&H, FQHCPart B). If the debt is not repaid within the specified timeframes (following the different timeframes for Part A and Part B), it will go to the demand process and they will get the demand letter, they then have 30 days before interest accrues.

  • What will be the interest rate once interest starts to accrue?
    The current interest rate is 10.25%. The interest rate is subject to change and we cannot speak to what a future interest rate will be. These rates are published through recurring CRs. Here is the most recent Change Request 11653

Common Reasons NGS Returns or Denies Accelerated/Advance Payment requests

  • The form specified a rendering provider NPI instead of the billing provider NPI.

  • The form was mistakenly submitted to NGS instead of the correct MAC.  Be sure so send the application to the MAC who processes your Medicare fee-for-service claims.

  • The billing provider has not billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/supplier’s request form.

  • Application request did not include a dollar amount.The provider is in bankruptcy.
    • Qualified providers/suppliers will be asked to request a specific amount using an Accelerated or Advance Payment Request form provided on each MAC’s website. Most providers and suppliers will be able to request up to 100% of the Medicare payment amount for a three-month period. 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. Critical access hospitals can request up to 125% of their payment amount for a six-month period.

  • The provider is under active program integrity investigation. 

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