Yes, there are emergency payments available to Medicare providers. No, they are not all grants, some are loans. Know the rules; know the differences between the two; know the consequences of accepting your payment.
CMS will begin distributing $30 billion of the $100 billion Congress allocated in an emergency provider relief fund this week. The first round of grant funds from the Coronavirus Aid, Relief, and Economic Security Act will be distributed based on Medicare revenue, according to CMS Administrator Seema Verma.
Some of the payments will be issued by direct deposit, while other providers will be required to register to receive the grants."This is not based on a first-come, first-served basis. Because we are basing this on the Medicare revenue, they will get these dollars," Verma said.
The American Hospital Association had asked for more than $20 billion to be allocated exclusively to hospitals based on facilities' number of hospital beds. Verma said there will be a second round of funding where priority will be given to children's hospitals, pediatricians, nursing homes and other providers that receive much of their funding from other sources.
It is unknown how much, if any, will be left over for post-acute care providers. HHS has not yet released details about how the rest of the money will be spent, or how money may be used to pay for COVID-19 care for the uninsured. Hospital groups have generally opposed that use for the emergency funds.
An analysis by the Kaiser Family Foundation released Tuesday estimated that hospital costs for the uninsured could be as high as $42 billion.
In a separate announcement Tuesday, the CMS said it had sent $34 billion to providers over the past week through its Accelerated and Advance Payment Program. This money is different from the CARES Act funding.
The agency said that it received more than 25,000 requests from providers and suppliers under the program, which was expanded in late March to address cash-flow issues due to the coronavirus pandemic. More than 17,000 requests were approved last week. Prior to COVID-19, about 100 total requests were approved in the past five years, mostly after a natural disaster, the agency noted.
CMS has published a Fact Sheet detailing these advance payments, which we have posted here.
According to Medicare reimbursement consultant John Reisinger, CEO and founder of Innovative Financial Solutions for Home Health, the creators of the Home Health Resource Planner software tool, Medicare certified home health agencies that have billed Medicare for claims within the previous 180 days are eligible to apply for advance payments. Other requirements, listed on the Fact Sheet, include not currently being in bankruptcy, under active medical review or program integrity investigation, nor having any outstanding delinquent Medicare overpayments.
"This is where you can request up to 100% of 3-months of Medicare payments to carry you over during this pandemic," Reisinger told us. "Just be aware that you will have to pay it back. The 3-months in advance payments you obtain via this program could turn into a 3-month period in the future that you do not receive any Medicare cash while your loan is recouped."
He added that, according to the Fact Sheet, this would happen between days 121 & 210 (inclusive) after receipt of the advanced payment. "It can become complex and problematic if you do not properly prepare for the recoupment period, when your Medicare cash-flow will dry up for most of that date range. Proper planning will be required to make this an almost seamless event."
"Applying for the advance payments is not complex," Reisinger concluded. "Initiate the process with your Medicare Administrative Contractor."
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