Background on Sped up and Advance Bills
In March of 2020, CMS expanded the COVID-19 Sped up and Advance Bills (CAAP) Program to further Medicare Section A suppliers and Section B providers according to the COVID-19 pandemic. An speeded up or advance fee is a fee this is designed to assist money go with the flow disruptions all over a countrywide emergency.
Consistent with the CARES Act and beneath the Proceeding Appropriations Act, 2021 and Different Extensions Act, reimbursement beneath the CAAP Program starts 12 months from the date of each and every issued fee to a supplier or provider.
CMS announcement and reimbursement phrases
On April 1, 2021, CMS introduced that, starting March 30, 2021, it all started getting better CAAPs won via Medicare suppliers and providers whose 12 months reimbursement date is up.
A supplier or provider would possibly pay off their CAAP via contacting their Medicare Administrative Contractor (MAC). If such CAAP is repaid in complete, the reimbursement phrases famous under is not going to practice.
If a CAAP isn’t repaid in complete (as detailed above) the next reimbursement phrases will practice:
- The reimbursement procedure will start mechanically. Compensation for each and every CAAP will start 12 months from the issuance date of such fee.
- As soon as repayments start, Medicare suppliers and providers will proceed to post claims, however a portion of the brand new claims shall be offset to pay off the CAAP (25% all over the primary 11 months of reimbursement and 50% all over the following 6 months).
- If the CAAP isn’t paid in complete after month 29, the MAC will factor a requirement letter to the supplier or provider inquiring for fee of the rest steadiness. If fee isn’t won in complete inside 30 days from the date of the letter, passion will start accruing at the remarkable steadiness at a fee of four%.
- If a supplier or provider won a CAAP and not reopened his/her supplier or provider location, then the supplier or provider isn’t penalized however shall be required to pay off the whole quantity on the finish of the 29 month duration. MACs will factor letters for any remarkable balanced owned as detailed above.
If experiencing monetary hardship, suppliers and providers are inspired to achieve out to their MAC to request an Prolonged Compensation Agenda (ERS) after a requirement letter is issued. An ERS is a debt installment fee plan, which permits a supplier or provider to pay their money owed over a 3 12 months duration. In circumstances of maximum hardship, the plan may also be prolonged as much as 5 years.
Nicole Jobe and Elisabeth Volk are participants of Thompson Coburn’s Well being Care observe workforce.