Healthcare Provider Solutions


Welcome to Monday Minute with Melinda! This video clip will recap the process of Medicare recouping the Accelerated and Advance Payments from 2020.

Hello everyone, Welcome to our Monday Minute. Today we’re going to discuss the Advanced and Accelerated Payments that agencies are going to be responsible for returning to Medicare. CMS, Last year, at the beginning of the pandemic, In April or so of 2020, Home Health agencies and Hospices alike were allowed to request advanced payments from the Medicare MAC to the tune of approximately three months of reimbursement that they would typically see. at that point, made a calculation to determine the maximum amount any one agency would be allowed to request from the Medicare MAC. Then you had to fill out a form, submit it to your Medicare MAC, either requesting the maximum amount or an amount lesser than that. Once those funds were distributed, you were told that 120 days from the time that you received those funds, they would be recouping that money at 100% until they recovered the full amount. In August of 2020, which is basically the time period that would have been about the beginning of the 120 days from the first distributions, nothing happened. Inquiries were made, and finally, we received information in approximately October of 2020, to tell us that they had changed their mind about the way they were going to recoup and the timing of the recoupment.

They announced that they would be recouping the amounts beginning one year from the time that the funds were distributed. So if you received a distribution in April of 2020, your recoupment will begin in April of 2021. When that recoupment begins, they will be recouping 25% of your Medicare reimbursement amounts as you bill final claims for the first 11 months of the recruitment process. Once they get to the end of 11 months, if by deducting 25% of your reimbursement you have not fully paid back the amount that you had originally been advanced, they will then, for the next six months, recoup at 50%. After the end of that six months, which is now a total of 17 months, if there is still a balance left from the advanced payments you were given, they are going to issue a letter telling you the remaining balance that you have. Within 30 days, they will begin accruing interest at the rate of 4%.

I wanted to share this with you today because the one year timeframe is coming up very, very quickly. In fact, April of 2021 is when most of this should begin. We have had no information from CMS whatsoever that this will be delayed. However, we didn’t get told until the last minute and even after the last minute last year when it was supposed to happen in August, that it wasn’t going to happen in August. I want to make sure that you are prepared for the reality of the fact that it is likely going to start recoupment in April.

Thank you all for joining me today. I hope this has been helpful. If there is or were to be an update to the recoupment beginning in April of 2021, we will make sure to let you know. Thank you as always for taking care of patients during this public health emergency. If you need additional information regarding these advanced accelerated payments feel free to give us a call or send us an email or contact your state Home Care Associations. HPS is always here to support you.

If you enjoyed today’s content be sure to check out the HPS Alliance where members receive exclusive content, webinars, and ongoing updates from our industry-leading educators. The following webinar discusses both the advanced accelerated payments and the provider Relief Fund reporting that is going to start shortly, but has not begun as of yet: AAP & Provider Relief Funds.