Part B Insider (Multispecialty) Coding Alert

Published on Mon Oct 19, 2020 PDF

Congress prompts CMS to alter repayment rules.

With the pandemic still hitting Medicare providers hard, the feds decide to offer a loan recoupment olive branch and push out the deadlines.

Reminder: Last spring, the Centers for Medicare & Medicaid Services (CMS) expanded its Accelerated and Advance Payment (AAP) program issuing over $106 billion to providers dealing with COVID-19-related, cash-flow issues. From the outset, the agency offered very strict guidelines for paying the loans back when the payments were first disbursed, setting the recoupment start date at 120 days from issuance.

Now: On Oct. 8, CMS announced it would alter the repayment terms to align with Congress’ recently passed Continuing Appropriations Act, 2021 and Other Extensions Act, giving providers more time.

The Act requires CMS to do the following:

• Delay recoupment of disbursements to 365 days from the date the advance payment was issued.
• Cut the per claim recoupment to 25 percent for the first 11 months and 50 percent for the following six months.
• Reduce the interest rate on the payments to 4 percent.
• Give providers 29 months to pay the balance in full.

Resource: Review the fact sheet on the policy change at www.cms.gov/files/document/accelerated-and-advanced-payments-fact-sheet.pdf.