COVID-19 Payments for Providers

In the wake of COVID-19, the government has created many types of plans to help ease financial burdens, including burdens faced by healthcare providers. These plans can be complicated and difficult to understand.

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While you’ve likely heard about various payment programs and the CARES Act, you may not be aware of all of the funding programs that have been created for providers.

We wanted to make you aware of some of the programs for eligible healthcare providers. Please note, these programs may change and the rules surrounding them also continue to evolve.

First, the Accelerated and Advanced Payment Program (AAPP) was created to provide funding when there is a disruption in your claims submission and processing.

To be eligible for AAPP, you must:

  • Not be in bankruptcy,
  • Not have active medical review or a program integrity investigation,
  • Have billed Medicare for claims within 180 days prior to the signature on the provider’s request form, and
  • Not have outstanding delinquent Medicare overpayments

In regards to AAPP payments, there are no restrictions on the use of the funds and no further service. There are also no appeal rights related to the payments.

But providers should make sure to understand repayments and repayment deadlines.

Another source of funding is the Provider Relief Fund (PRF).

There is no repayment expectation under PRF for eligible providers who make eligible expenditures. Providers can qualify if:

  • They received Medicare fee-for-service reimbursements in 2019,
  • They provided diagnosis for individuals with possible or actual COVID-19 after January 31, 2020,
  • They are not currently terminated from participation in Medicare or excluded from participating in a Federal healthcare program, and
  • Their Medicare billing privileges are not revoked.

PRF can be used to prepare for and respond to COVID-19 and to reimburse for healthcare expenses or lost revenues due to COVID-19.

PRF may not be used for expenses that have been otherwise reimbursed.

Please note – reports may be subject to audit and inspection. It is essential that you document use of the funds and keep accurate logs. If you have any questions, contact your healthcare attorney!

If you have questions about other funds and the potential impact your practice, let us know!

In our next blog post, we will keep you informed of related issues.  To get this important information delivered directly to your mail box, 

Do you need help staying current and compliant with the latest laws, rules and regulations?  We can help. To contact us about your new government rules and regulations, your practice’s risk assessment, or about your other legal needs:  CLICK HERE.

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