Medicare Accelerated and Advance Payment (AAP) Repayments to Begin

Medicare AAP repayments will begin for all Medicare providers who received AAP payments one year from the date of receipt.  For many SNFs, repayment dates begin in April 2021.  Providers do not need to take any action to repay. Medicare Administrative

Contractors (MACs) will begin to automatically recover payment amounts by reducing paid claims until the AAP is repaid.  Beginning at one year from the date the payment was issued and continuing for eleven (11) months, Medicare payments owed to providers and suppliers will be recouped at a rate of 25%. After the eleven (11) months end, Medicare payments owed to providers and suppliers will be recouped at a rate of 50% for another six months.

After the six months ends, MACs will issue letters for the remaining balance of the accelerated or advance payments. If a letter requiring reimbursement is issued, providers and suppliers will have 30 days from the date of the letter to repay the balance in full.  If payment is not received within 30 days, 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.  Information related to Extended Repayment Schedules (ERS) will be included in these letters. Providers and suppliers will only be able to request ERSs after the 30-day demand letters are issued.  You can read the CMS guidance at this link under Section 50.