What’s new: A provision to facilitate medical practices that have received funds from the Medicare Accelerated and Advance Payment (AAP) programs is contained in the CR Congress (Continuing Resolution), which must be passed by December 11th to fund the federal government.
The AAP programs provided a lifeline for practices that closed their doors or noted a significant decrease in patient volume during the COVID-19 pandemic. However, the repayment is due and the financial terms are tough. The AMA has called on Congress and the Centers for Medicare & Medicaid Services (CMS) act to keep doctor’s offices viable and open to patients during the pandemic.
Without the repayment terms changes in the CR, doctors would have withheld 100% of their Medicare claims to repay the loans in just 120 days. Outstanding balances would earn interest within a few months at an interest rate of 10.25%.
“With the rolling resolution passed, patients should know that their doctor is more likely to be able to handle the economic challenges of the pandemic,” said AMA President Susan R. Bailey, MD. “Congress recognized the danger and rightly changed the program so that doctors can continue to see patients.”
The rolling resolution:
- Postpones the repayment of amounts paid to 365 days after the prepayment is issued to a doctor’s office; The balance would be due by September 2022.
- Reduces the repayment amount per claim in the first 11 months from 100% to 25% and the 50% of the claims that are withheld for a further six months. If the repayment is not made in full, the interest rate starts at 10.25%.
- The interest rate would be reduced from 10.25% to 4%.
Why it matters: The AMA applauded CMS back in March when the agency expanded eligibility for the AAP programs, which provide an emergency cash advance based on a practice’s historical Medicare payments to provide the funds needed if claims filing or processing is disrupted – for example in the COVID-19 pandemic.
That move met a critical need and resulted in CMS approving nearly 24,000 applications for a total of $ 40.4 billion in upfront payments to doctors, healthcare professionals and other Medicare Part B suppliers at the start of the pandemic.
Surveys found that doctor’s office income decreased by at least 50% from March to May. In reopening the practices, some, but not all, have made up for this loss due to reduced visits and procedures.
“Members of Congress and the administration have agreed on a bipartisan response to the economic sword hanging over medical offices,” said Dr. Bailey. “That relief will be felt across the country as doctors can continue to provide medical care during the pandemic.”
What’s next: The measure was passed by the US House of Representatives earlier this week. It now has to pass the Senate and is expected to be signed by President Trump before September 30th.
Read about everything the lobbying work of the AMA during the COVID-19 pandemic and follow developments with theAMA’s COVID-19 Resource Centerwho have a library of resources from theJAMA network™, Centers for Disease Control and Prevention and the World Health Organization.