The Centers for Medicare and Medicaid Services (CMS) has announced a nationwide expansion of the Medicare Accelerated and Advance Payment Program (AAPP) to help providers and suppliers during the COVID-19 pandemic. Orthotic and Prosthetic (O&P) practices will be able to access expedited and advanced payments in order to fund their operations and increase cash flow during the crisis due to disruptions in claims submissions and processing. CMS’ fact sheet detailing eligibility and the application process can be found here.
What is Available?
Under the AAPP, O&P practices may essentially borrow against their expected future Medicare payments in order to maintain necessary financial resources during the COVID-19 crisis. O&P practices will be able to request advance payments up to 100% of their Medicare payments for a three-month period (between October and December 2019). Through the DME MACs, CMS will work to provide the requested payments within 7 calendar days of the application. Advance payments will be available throughout the public health emergency.
Who is Eligible?
With the expansion of the AAPP, providers participating in Medicare Part A and suppliers in Medicare Part B will be able to apply for and receive accelerated and advance payments. Specific eligibility criteria are outlined in the CMS fact sheet linked above, but current Medicare providers and suppliers in good standing (i.e., no delinquent payments owed to Medicare, not in bankruptcy, not currently under investigation) are eligible.
How Do I Apply?
CMS has published a step-by-step guide for applications in their AAPP fact sheet linked above. O&P practices should fill out a Request Form, which is provided by their individual region’s DME MAC. Forms are published on each MAC website and providers and suppliers can also contact their MAC’s COVID-19 hotline for assistance. To identify your region’s designated MAC, click here. The Request Form must be executed by an authorized representative, and suppliers/providers should state on the Request Form that they are experiencing cash flow problems due to COVID-19. Electronic submission is strongly encouraged, but mail or fax is accepted.
What Happens After I Apply?
Assuming your O&P practice meets eligibility criteria, the MACs should issue requested payments within 7 calendar days of the request. For 120 days after the payment is issued, O&P practices can continue their usual claims submission process and receive full Medicare payments. After that period, newly submitted claims will not be paid out, but will be automatically offset against the practice’s outstanding balance on the AAPP payment. After 210 days from the date the payment was issued, a MAC will send a repayment request for any remaining balance. After that the interest rate is relatively high; about 10% on an annual basis. Therefore, advanced payments equate to a 210-day no-interest loan.
NAAOP recommends that all O&P practices explore taking advantage of this program. Whether you spend the advance payment or hold it in your account, this is a quick, no-cost way of helping to manage your practice’s cash flow during a very difficult time period. O&P practices should also consider applying for small business loans, which are forgivable if certain criteria are met. See NAAOP’s post on the Paycheck Protection Program.