CMS to Provide Accelerated & Advance Payments to Providers Impacted by Helene
In response to the cashflow challenges that providers will face in the aftermath of Hurricane Helene, and in response to the declared Public Health Emergency, CMS will provide accelerated and advanced payments to Medicare providers and suppliers impacted by the storm, beginning October 2, 2024. Physician practices are considered “Part B suppliers.”
Medicare providers and suppliers in need of this assistance should our state’s assigned Medicare Administrative Contractor (MAC), which is Palmetto GBA.
The CMS press release with additional information is below.
The U.S. Department of Health and Human Services (HHS) through the Centers for Medicare & Medicaid Services (CMS) is taking action to support providers and suppliers impacted by Hurricane Helene within the Federal Emergency Management Agency (FEMA) disaster zones, under the President’s major disaster declarations. These providers and suppliers may face significant cash flow issues from the unusual circumstances impacting facilities’ operations, preventing facilities from submitting claims and receiving Medicare claims payments. As a result of the presidential disaster declaration, and HHS public health emergencies declared in the wake of Hurricane Helene, CMS made available accelerated payments to Medicare Part A providers and advance payments to Medicare Part B suppliers affected by Hurricane Helene beginning October 2, 2024.
Accelerated and Advance payments related to Hurricane Helene may be granted in amounts equal to a percentage of the preceding 90 days of claims payments. These payments will be repaid through automatic recoupment from Medicare claims for a period of 90 days following the issuance of the accelerated or advance payment. A demand will be issued for any remaining balance on day 91 following the issuance of the accelerated or advance payment.
In addition, CMS has made available certain flexibilities related to provider and supplier fee-for-service Medicare debt, as detailed below.
Available Assistance:
Accelerated and Advance Payments to Eligible Providers/Suppliers: Providers and suppliers located in, or furnishing services within, a FEMA designated disaster area established as a result of Hurricane Helene, and who are enrolled in Medicare with an approved provider agreement, are eligible for Hurricane Helene accelerated or advance payments. To request these payments, providers and suppliers must meet the following criteria:
- The provider/ supplier has billed Medicare for claims during the 90 days prior to the aftermath of the natural disaster.
- The provider/supplier is enrolled in the Medicare program and has not been revoked, deactivated, precluded, or excluded by CMS or the HHS Office of the Inspector General. The provider/ supplier does not have any outstanding accelerated and advance payments pending for more than 90 days.
- The provider/supplier does not have any delinquent amounts due under Medicare. Delinquent debt does not include debt that is under an approved Extended Repayment Schedule, where payments have been made in accordance with the schedule.
- The provider/supplier is not on a Medicare payment hold or payment suspension.
- The provider/ supplier must not be under investigation for fraud, waste, or abuse related issues.
- Providers receiving Periodic Interim Payments are not eligible for accelerated payments.
Please note, Hurricane related accelerated and advance payments must be requested for individual providers/suppliers – i.e. unique National Provider Identifier (NPI) and Medicare ID (PTAN) combinations.
Flexibility for Existing Extended Repayment Schedules: For providers and suppliers currently repaying debt under an Extended Repayment Schedule (ERS) established at the maximum 60-month term, the provider/ supplier may restructure their payment schedule for two consecutive monthly payments during the approved period not to exceed a total of 60 months of ERS payments in their schedule without requiring additional financial documentation. For providers/ suppliers currently repaying debt under an Extended Repayment Schedule (ERS) established at less than a 60-month term, those providers/ suppliers may request an additional two months be added to their existing ERS, subject to the 60-month maximum. The additional two months shall be interest only payments, or $0 payments, with remaining payments adjusted to account for interest that accrues during the period in which the payment schedule was modified.
Disrupted Debt Communications: For providers and suppliers that do not receive a letter requiring the repayment of an overpayment resulting from disruptions to the United States Postal Service delivery of first-class mail, providers and suppliers may request affected overpayment demand letters be rescinded and reissued at a time when the availability of mail service has been reestablished.
Medicare providers and suppliers in need of this assistance should contact their assigned Medicare Administrative Contractor.
MAC Contact Information
A list of MACs can be found at our CMS.gov website at: https://www.cms.gov/mac-info.