AHA wants improvements for Accelerated Medicare Payments

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AHA wants improvements for Accelerated
Medicare Payments
The American Hospital Association (AHA) is
calling on CMS to re-evaluate payment options for
hospitals that accepted accelerated Medicare
payments at the early stage of the COVID-19
pandemic. The hospital group requested CMS
Administrator Seema Verma to allow all hospitals
to elect to receive periodic interim payments
(PIP) or accelerated payments, per initial CMS
communications about the COVID-19 support
option. Thomas P. Nickels, AHAs executive vice
president, told CMS Administrator Seema Verma in
an Aug. 3rd letter For the past four months,
PIP hospitals have had the expectation
communicated by CMS that their accelerated
payment repayment would occur at final cost
settlement, which generally would be many months
from now. PIP hospitals receive Medicare
reimbursement biweekly Based on the facilitys
estimate of Medicare payments for the current
cost reporting period, PIP hospitals are
receiving Medicare reimbursement biweekly.
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AHA wants improvements for Accelerated
Medicare Payments
CMS expanded eligibility for accelerated Medicare
payments to a broader set of hospitals, health
professionals, and suppliers during the COVID-19
public health emergency to help financial
losses. According to AHA, CMS indicated during a
call with hospitals in April that PIP hospitals
would get the accelerated Medicare payments in
addition to their periodic payments and the
reconciliation process for the accelerated
payments would occur at the final cost report
process for the first cost reporting after the
repayment period. The accelerated payment fact
sheet written by CMS stated, For the small
subset of Part A providers who receive Period
Interim Payment (PIP), the accelerated payment
reconciliation process will happen at the final
cost report process (180 days after the fiscal
year closes). CMS has directed Medicare
Administrative Contractors (MACs) to implement
the same repayment process for PIP hospitals as
non-PIP hospitals, meaning PIP hospitals would
have their periodic payments held back until the
accelerated Medicare payments were repaid,
recently communicated by MACs to AHA hospitals.
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AHA wants improvements for Accelerated
Medicare Payments
Thomas P. Nickels, AHAs executive vice president
wrote, The result is that PIP hospitals will go
several months without any Medicare inpatient
reimbursement, which is contrary to the entire
purpose of the PIP program to provide hospitals
with a steady and predictable revenue stream.
Moreover, hospital inpatient and outpatient
volumes are down nearly 20 and 35,
respectively, from 2019, and most do not expect
volume to return to baseline levels in
2020. The AHA estimates an additional 120.5
billion in total financial losses from July 2020
through December 2020 should hospitals and health
systems reach baseline patient volumes by July
2021, or an average of 20.1 billion per month.
These estimates are in addition to the 202.6
billion in losses the AHA estimated between March
2020 and June 2020 bringing the total projected
losses to hospitals and health systems in 2020 to
at least 323.1 billion. The AHA is advocating
for more flexible repayment options, the group is
also urging CMS to consider full forgiveness of
accelerated payments for all hospitals.
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AHA wants improvements for Accelerated
Medicare Payments
Additionally, Nickels wrote in the letter
Providers will continue to face historic
challenges throughout this extended public health
emergency and beyond, as we expect the immense
financial strain facing hospitals and health
systems due to COVID-19 will continue through at
least the end of 2020. Forgiving hospitals
accelerated payments is necessary for providers
to recover and rebuild while delivering the care
that patients and communities are depending
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