Essential Information:

The CARES Act, enacted into law on Friday, March 27, in addition to a CMS Press Release on Saturday, March 28, comprise two new major funding opportunities for COVID-19 related costs and expenses for certain eligible healthcare providers. This funding is separate from Public Assistance available through FEMA. Apply for funding as soon as possible to ensure that your organization can access this newly available funding. Advis is available to assist with initial applications. We can assist as well with ongoing cost and expense management throughout the duration of the funding lifecycles.

Advis has provided some FAQs regarding these two aid opportunities below:

CARES Act – $100B in Funding for Healthcare Providers

Who is eligible to apply for the funding? HHS has broadly defined eligible applicants as all Medicare/Medicaid enrollees, including for-profit entities.

What costs and expenses are considered eligible? Broadly defined, eligible expenses are those related to addressing the COVID-19 national emergency. Expenses could include (but are not limited to) the construction of temporary structures, leasing of properties, medical supplies and equipment, including personal protective equipment and testing supplies, increased workforce and trainings, emergency operation centers, retrofitting facilities, surge capacity, etc.

How will funding distribution be prioritized?  Funds are available until expended, which means it is crucial for eligible applicants to submit requests ASAP.

What sort of records do I need to maintain to justify my costs? Applicants should begin preparing cost models now. Recipients of CARES Act funding must submit ongoing reports and documentation that sufficiently justify costs and expenses to HHS

Accelerated and Advance Payment Program

What is the Accelerated and Advance Payment Program? A Federal program that provides necessary, prospective funds when there is a disruption in claims submission and/or claims processing, including national emergencies, such as COVID-19. Note: these payments are advances on future reimbursement and will need to be repaid to Medicare or offset against future reimbursement.

Who is eligible for the Accelerated Payment Program (“APP”)? All Medicare providers including hospitals, doctors, DME suppliers, and other Medicare Part A and Part B providers and suppliers. Those applying should ensure that the application is signed by the Authorized Official as listed on their Medicare 855A/B record.

How to qualify for accelerated or advanced payments? Provider/Supplier must meet the following qualifications:

    • Billed Medicare claims within 180 days immediately prior to the date of signature on the provider’s/supplier’s request for accelerated payments;
    • Not be in bankruptcy;
    • Not be under active medical review or program integrity investigation; and
    • Not have any outstanding delinquent Medicare overpayments.

How much is an eligible applicant able to receive in advance? Most providers/suppliers may receive up to 100% of the Medicare payment amount for a 3-month period. Inpatient acute care hospitals, children’s hospitals, and certain cancer hospitals may request up to 100% of the Medicare payment amount for a 6-month period. Critical access hospitals can request up to 125% of their payment amount for a 6-month period.

How soon will an applicant receive payment? Within 7 calendar days of the request.

After receiving payments, when will they need to be paid back? After 120 days, Medicare will begin recouping payment. Repayment is first offset against newly submitted claims. Any remaining balance will be due within 1 year for most hospitals (i.e. inpatient acute care hospitals, children’s hospitals, certain cancer hospitals, and critical access hospitals). All other providers will have 210 days.

For more information, please contact Advis using our online form or at 708-478-7030

Published: March 30, 2020