The Centers for Medicare & Medicaid Services (CMS) announced that it has suspended its Advance Payment Program to Part B suppliers and reevaluating all pending and new applications under the Part A Accelerated Payment Program. The agency suggested the program is no longer necessary, although some physician groups disagree.
CMS announcement
CMS is “reevaluating the amounts that will be paid under its Accelerated Payment Program and suspending its Advance Payment Program to Part B suppliers effective immediately,” according to a press release issued by CMS. “The agency made this announcement following the successful payment of over $100 billion to healthcare providers and suppliers through these programs and in light of the $175 billion recently appropriated for healthcare provider relief payments,” the agency said.
After expanding these temporary loan programs on March 28, 2020, to increase cash flow to Medicare suppliers and providers impacted by the 2019 COVID-19 pandemic, CMS approved over 21,000 applications totaling $59.6 billion in payments to Part A providers, including hospitals, and approved almost 24,000 applications totaling $40.4 billion in payments to Part B suppliers, including physicians. In making this policy change, CMS explained that expansion of the loan programs was intended to ensure providers and suppliers had the resources needed to combat the beginning stages of COVID-19. Loan recipients will be obligated to repay the advanced/accelerated payments, with repayment obligations commencing 120 days from the loan distribution, with limited exceptions.
Physician groups had previously taken issue with some of the terms of the Advance Payment program. “We urge CMS to continue to work towards further decreasing processing time for applications and to extend the amount of time by which physicians would have to pay back Medicare for advance payments,” Robert McLean, MD, president of the American College of Physicians (ACP), said in an April 15 letter to the agency.
“Specifically, the College strongly recommends that this loan payment timeframe be extended to at least a year from the date that the load payment is received. Given the economic uncertainty surrounding this pandemic, extending the payback timeline would give physicians additional flexibility to weather an ever-changing economic forecast.”
However, as reported by MedPage Today, physician organizations still were not pleased about its suspension. “Physician practices across the country are struggling to keep their doors open,” American Medical Association president Patrice Harris, MD, said in an email to MedPage Today. “Advanced payments offer an important lifeline for cash-strapped practices to weather these financially challenging times, and they are always repaid, which distinguishes them from the programs Congress replenished last week.”
“From speaking with Trump administration officials, we understand that CMS is pausing the program to evaluate how physicians and other providers are using it as well as the CARES Act Provider Relief Funding,” Harris continued. “Now more than ever, we need physician practices on strong financial footing and open to combat COVID-19. We urge the administration to restart the program as soon as possible.”
The American Academy of Family Physicians (AAFP) also expressed concern. “Family medicine practices facing financial issues likely have already pursued relief through the Advance Payments Program,” Shawn Martin, the AAFP’s senior vice president of advocacy, said in an email to MedPage Today. “However, the situation remains fluid for most practices and the administration has now taken away one option to secure financial support during this crucial time.”