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CMS Allows Medical Groups to Borrow From Future Medicare Payments

March 31, 2020

KSM Healthcare Resources Group

Update: As of April 26, CMS has suspended the Advance Payment Program for Medicare Part B participants.

The coronavirus pandemic has upended the normal operations of nearly all medical groups. Whether you are experiencing a surge in patient volume or a devastating drought, maintaining cash flow is a chief concern.

To help address liquidity, the Centers for Medicare and Medicaid Services (CMS) announced it has expanded its Accelerated and Advance Payment Program, which allows physicians and medical groups to request an advance on their Medicare payments. Groups may request up to 100% of their Medicare payments for a three-month period, but recoupment will start automatically 120 days after receipt. At that time, claims will be used to reduce the advanced amount.

This program, which has been expanded under the Coronavirus Aid, Relief, and Economic Security (CARES) Act, is essentially an interest-free bridge loan. Providers should keep in mind the advance payment is exactly that; cash received now must be paid back in four months. Assuming payment is received in April, repayment would start in August. Because of this, providers should not advance more than is needed for payroll and business continuity.

This advanced payment is available to all Medicare providers that are in good standing, which includes the following criteria:

  • Billed Medicare within 180 days from the date of the request
  • Not in bankruptcy
  • Not under active medical review or program integrity investigation
  • No outstanding delinquent Medicare overpayments

Hospitals have slightly different requirements but are generally the same as Part B providers.

This program is administered by Medicare Administrative Contractors (MAC). Providers may locate their MAC on the CMS website.

We will be glad to assist you in completing the request form and answering any questions you may have regarding this process. Please reach out to your KSM advisor or complete this form, and one of our professionals will be in touch.

Visit the KSM COVID-19 Resource Center

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