Continuing Appropriations Act Modifies Accelerated Payment Program & CMS Issues Corresponding Guidance

On October 1, 2020, President Trump signed into law H.R.8337:  Continuing Appropriations Act, 2021 and Other Extensions Act.  The Continuing Appropriations Act provides continued Fiscal Year 2021 appropriations to federal agencies through December 11, 2020, essentially extending the current budget through the December 11^th date.  Of particular interest to nursing facilities, the Continuing Appropriations Act also modified the Accelerated and Advance Payment Programs under Medicare Parts A and B that were implemented as a result of the public health emergency.

Then on October 8, 2020, the federal Centers for Medicare and Medicaid Services (CMS) issued guidance on the changes made to the Accelerated and Advance Payment Programs by the Continuing Appropriations Act.  CMS’s guidance can be found here and a corresponding FAQ document can be found here.

Under the Continuing Appropriations Act and the corresponding CMS guidance, the updated loan repayment terms of the Accelerated and Advance Payment Programs are as follows:  

• One Year Delay:  Overall, repayments for both Part A and Part B providers will not begin until at least one year from the date of the original payment from CMS.
• Staggered Recoupment: Beginning one year from the date the payment was issued and continuing for 11 months, Medicare payments owed to providers and suppliers will be recouped at a rate of 25% by CMS.  After the 11 months end, Medicare payments owed to providers and suppliers will be recouped at a rate of 50% by CMS for another six months.  After the six months end, a letter for any remaining balance of the accelerated or advance payment(s) will be issued.  Providers will have 30 days from the issuance of the letter to repay the remaining amount before interest begins.
• Lower Interest Rate:  The Act lowered the interest rate for loan payments from 10% to 4%.  Accordingly, 30 days after the issuance of the letter, interest will accrue at the rate of 4% from the date the letter was issued  and will be assessed for each full 30-day period that the balance remains unpaid.
• Lump Sum Payments: In a departure from previous policy, providers and suppliers now have the option to submit one or more lump sum payments to pay off all or some of their total balance, although lump sum payments are not required.  To arrange a lump sum payment, CMS indicates providers and suppliers should contact their MAC(s) for more instructions on how to make a lump sum payment, especially if payment will be made after the repayment timeframe begins.

For questions related to the Accelerated and Advance Payment Program, CMS has established COVID-19 hotlines at each MAC that are operational Monday through Friday to assist all providers with accelerated or advance payment concerns.  Providers should contact the MAC that serves their geographic area(s).  To locate designated MAC areas, refer to the MAC Contact section of this document or visit the MAC website list.