Medicare Suspends Advance Payment Program for Docs

Medicare giveth and taketh.

Centers for Medicare and Medicaid Services (CMS) has suspended its Advance Payment Program to Part B suppliers immediately on April 26, 2020 and is reevaluating all pending and new applications under the Part A Accelerated Payment Program.

Medicare Part A covers hospital expenses, hospice, and home health care. Medicare Part B covers outpatient medical care such as doctor visits, X-rays, bloodwork, and routine preventative care.

This step was being taken following the “successful payment of over $100 billion to healthcare providers and suppliers through these programs and in light of the $175 billion recently appropriated for healthcare provider relief payments,” the agency said in an April 26, 2020 press release.

At the start of the COVID-19 pandemic, CMS approved over 21,000 applications totaling $59.6 billion in payments to Part A providers, including hospitals, and approved almost 24,000 applications totaling $40.4 billion in payments to Part B suppliers, including physicians.

Loan recipients have to repay the advanced/accelerated payments, with repayment obligations commencing 120 days from the loan distribution, with limited exceptions.

Then American Medical Association President Patrice Harris, M.D., said in an email to MedPage Today. “Advanced payments offer an important lifeline for cash-strapped practices to weather these financially challenging times, and they are always repaid, which distinguishes them from the programs Congress replenished last week.”

“From speaking with Trump administration officials, we understand that CMS is pausing the program to evaluate how physicians and other providers are using it as well as the CARES Act Provider Relief Funding,” Harris continued. “Now more than ever, we need physician practices on strong financial footing and open to combat COVID-19. We urge the administration to restart the program as soon as possible.”

The agency reminded providers that “significant additional funding” will continue to be available to hospitals and other healthcare providers through other programs. Congress appropriated $100 billion in the Coronavirus Aid, Relief, and Economic Security (CARES) Act (PL 116-136) and $75 billion through the Paycheck Protection Program and Health Care Enhancement Act (PL 116-139) for healthcare providers. HHS is distributing this money through the Provider Relief Fund, and these payments do not need to be repaid.

For more information on the CARES Act Provider Relief Fund and how to apply, click here.