Medical Business Advisory / Medicare AAPP Recoupment Terms Finalized

Medicare AAPP Recoupment Terms Finalized

A sigh of relief can be heard amongst the medical community last week.  Lawmakers granted an extension for providers who had their Medicare payments advanced during the early stages of the COVID-19 public health emergency.

The bill gives part B providers 1 year (originally 120 days) before CMS begins to recoup payments made under the Accelerated and Advance Payment Program.  The repayments will be made via claim reimbursement offsets.  It also states that CMS will only offset a provider’s payments after the initial grace period by 25% of the payment amount on the EOMB for the first 11 months of repayment, and then 50% of the payment amount on the EOMB for the remaining 6 months for a total extension and repayment period of 29 months.

CMS will withhold Medicare payments after the 12-month grace period for a total of 17 months before requiring providers to repay the remaining balance in full. Additionally, the law reduced the interest rates on any outstanding balances from 10.25% to 4.0%.

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