To help ensure that health care providers have the resources necessary to care for patients during the COVID-19 pandemic, Congress and the Centers for Medicare & Medicaid Services (CMS) took action to provide direct financial support to providers who have been impacted by the emergency.
The Coronavirus Aid, Relief, and Economic Security (CARES) Act and new guidance from CMS both contain provisions to provide financial support to qualified providers. The American Society of Clinical Oncology (ASCO) strongly encourages providers to immediately begin meticulously documenting health care related expenses or lost revenues that are attributable to COVID-19 to ensure they can qualify for this support.
New COVID-19 Provider Fund
The CARES Act, which was signed into law on March 27, established a Provider Fund that includes $100 billion for eligible providers for health care related expenses or lost revenue attributable to COVID-19.
Based on an initial assessment of the legislation, ASCO believes that to be eligible for a payment, providers will need to submit an application to the Secretary of the Department of Health and Human Services that includes a statement justifying their need for payment. It is likely that recipients will also be required to submit reports and maintain documentation as to ensure compliance with conditions for receiving such payments. ASCO will provide additional details following a more detailed analysis of the legislation.
Expansion of the Accelerated and Advanced Payment Program
CMS released official guidance expanding its current Accelerated and Advance Payment Program to a broader group of Medicare Part A providers and Part B suppliers. The expansion of this program will only last for the duration of the COVID-19 emergency to increase cash flow to providers of services and suppliers impacted by the pandemic.
To qualify for advance/accelerated payments, providers and suppliers must:
- Have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/supplier’s request form,
- Not be in bankruptcy,
- Not be under active medical review or program integrity investigation, and
- Not have any outstanding delinquent Medicare overpayments.
Most providers and suppliers will be able to request up to 100% of the Medicare payment amount for a three-month period. Inpatient acute care hospitals, children’s hospitals, and certain cancer hospitals, however, may request up to 100% of the Medicare payment amount for a six-month period. CMS’ fact sheet about the program expansion has additional details and instructions on how to request advance/accelerated payments.