CMS Update and Fact Sheet - DoctorsManagement CMS Update and Fact Sheet - DoctorsManagement
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CMS Update and Fact Sheet

April 9, 2020

by Sean Weiss, Partner & VP of Compliance

https://www.cms.gov/outreach-and-educationoutreachffsprovpartprogprovider-partnership-email-archive/2020-04-09-mlnc

The link above is for CMS related news for today.

I have included the FACT SHEET ACCELERATED and ADVANCE PAYMENT Final update_0 for your review. Several clients have indicated that the guidance they received on the repayment of the accelerated medicare payments is that it’s 120 days. This is correct, but your repayment runs through 210 days and certain hospitals have up to one year for the repayment. Repayment: CMS has extended the repayment of these accelerated/advance payments to begin 120 days after the date of issuance of the payment. The repayment timeline is broken out by provider type below:

  • Inpatient acute care hospitals, children’s hospitals, certain cancer hospitals, and Critical Access Hospitals (CAH) have up to one year from the date the accelerated payment was made to repay the balance.
  • All other Part A providers and Part B suppliers will have 210 days from the date of the accelerated or advance payment was made to repay the balance.

The majority of hospitals including inpatient acute care hospitals, children’s hospitals, certain cancer hospitals, and critical access hospitals will have up to one year from the date the accelerated payment was made to repay the balance. That means after one year from the accelerated payment, the MACs will perform a manual check to determine if there is a balance remaining, and if so, the MACs will send a request for repayment of the remaining balance, which is collected by direct payment. All other Part A providers not listed above and Part B suppliers will have up to 210 days for the reconciliation process to begin. 

 

As I believed when I 1st sent out information on the CMS accelerated payment program, they used the term provider and suppliers under part B interchangeably and I believe the fact sheet confirms that. I am also awaiting confirmation from CMS. If anyone else has heard anything different please let me know.

I have also received requests from a few clients with regard to applying for the loan and/or grants if they are under an administrative review such as a UPIC. I’m waiting on guidance since several clients are in the appeals process. Also, those who completed the UPIC review and have had recoupment may be eligible since the review is over and it’s now an appeal. I will confirm today with CMS.

 

Sean M. Weiss is a Partner and serves as VP/Chief Compliance Officer for DoctorsManagement, LLC based in Knoxville, TN. DoctorsManagement, LLC services more than 20,000 clients nation-wide and has been in existence since 1956. Weiss serves as an Investigator and expert witness in Federal and State cases as well as an expert or lead in Administrative Law Judge Hearings. During his 25-year career, Weiss has engaged in more than 200 cases working with law firms and health systems across the country. Weiss serves as a third-party compliance and regulatory officer for more than a dozen health care organizations across the country of varying sizes. For more information on Sean M. Weiss or DoctorsManagement, LLC visit us online at www.doctors-management.com or contact us directly at 800.635.4040. You can also follow Sean on his biweekly Blog on LinkedIn (Sean M. Weiss “The Compliance Guy”) or at www.thecomplianceguyblog.com

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