Medicare Compliance & Reimbursement

Now: On Sept. 22, the House of Representatives approved the Continuing Appropriations Act, 2021 and Other Extensions Act (H.R. 8337), a continuing resolution that would fund the government through Dec. 11 and avoid a shutdown. Among many provisions, the bill would give Medicare providers a year before recouping accelerated payments. Despite a procedural hold-up, the bill passed in the Senate on Sept. 30.

The provision outlined in Section 2501 of the continuing resolution offers providers much needed relief and “lowers the interest rate, reduces the recoupment percentage and extends the periods before repayment periods begin and before full repayment is required,” summarizes law firm Brownstein Hyatt Farber Schreck LLP in online analysis.

The American Medical Association (AMA) cheered the bipartisan efforts in the House after months of advocacy on behalf of physicians, whose revenues have plummeted because of the coronavirus and have used the payments to keep their practices afloat.

“Members of Congress and the Administration have settled on a bipartisan response to the economic sword hanging over physician practices. This relief will be felt across the country as physicians will be able to continue providing health care during the pandemic,” said Susan R. Bailey, MD, AMA president in a statement on the bill.

The continuing resolution does the following:

• Delays recoupment of disbursements to 365 days from the date the advance payment was issued.
• Cuts the per claim recoupment to 25 percent for the first 11 months and 50 percent for the following six months.
• Reduces the interest rate on the payments to 4 percent from the originally mandated 10.25 percent, AMA
• Give providers 29 months to pay the balance in full.

Note: Read H.R. 8337 at https://appropriations.house.gov/sites/democrats.appropriations.house.gov/files/CR1_01_SUSP_xml.2020.9.22.1803 (002).pdf.