WASHINGTON, DC – While Capitol Hill buildings remain closed to the public and many staffers continue to work from home, Congressional offices are getting back to comparatively normal operations – including taking virtual meetings with constituents and advocacy groups about their policy priorities.
AAHomecare senior vice president for public policy Jay Witter has been meeting virtually with Congressional staffers for the last two months and reports that Capitol Hill offices have adapted well to virtual meeting technologies. Witter urges HME advocates to take advantage of the opportunity to make a strong impression without needing to travel to DC or a legislator’s district office.
“Making a connection to start or re-establish a relationship with Hill staff this Spring will help you make a stronger impression when we potentially need support on legislation or Congressional pressure on CMS later this year,” says Witter. “Whether you’re an experienced advocate or just starting to get engaged in HME policy, this is a great time to reach out.”
See more of Witter’s perspectives in this expanded article about engaging your legislators this Spring, including a discussion of key points and messages for your meetings, and help set the stage for more policy wins for HME this year!
Final Sequester Action Expected Soon
WASHINGTON, DC – As reported last week, the Senate passed an amended version of H.R. 1868, extending the pause on 2% Medicare sequester cuts though the end of 2021. With the moratorium on the cuts scheduled to end on April 1 and the House in recess, CMS announced a temporary hold on claims with dates of service on or after April 1 to give Congress time to finish work on the measure. The House is expected to take up the amended bill shortly after they return from their Easter recess on Apr. 13.
Updated Provider Relief FAQs Remind Providers on Need to Demonstrate Appropriate Use of Funds
WASHINGTON, DC – HHS recently updated the Provider Relief Fund (PRF) frequently asked questions (FAQ) document with modifications on many entries. HHS added more information on spending and returning funds, Terms and Conditions, ownership changes, reporting expenses, and other information related to the relief measures.
Suppliers that received funds from PRF’s General Distribution Phase 1 or 2 should be mindful that the Terms and Conditions of the funding requires recipients to demonstrate lost revenue and expenses due to COVID-19. Any funding that is not used by June 30, 2021 or made in error will need to be returned to HHS, as noted in these entries:
Does HHS intend to recoup any payments made to providers not tied to specific claims for reimbursement, such as the General or Targeted Distribution payments? (Modified 3/31/2021)
The Provider Relief Fund Terms and Conditions require that recipients be able to demonstrate that lost revenues and expenses attributable to COVID-19, excluding expenses and losses that have been reimbursed from other sources or that other sources are obligated to reimburse, meet or exceed total payments from the Provider Relief Fund. Provider Relief Fund payment amounts that have not been fully expended on health care expenses or lost revenues attributable to coronavirus by the end of the final reporting period must be returned to HHS. The Provider Relief Fund Terms and Conditions and applicable legal requirements authorize HHS to audit Provider Relief Fund recipients now or in the future to ensure that program requirements are met. Provider Relief Fund payments that were made in error, or exceed lost revenue or expenses due to COVID-19, or do not otherwise meet applicable legal and program requirements must be returned to HHS, and HHS is authorized to recoup these funds.
Is there a set period of time in which providers must use the funds to cover allowable expense or lost revenues attributable to COVID-19? (Modified 3/31/2021)
Yes. As explained in the notice of reporting requirements on the Provider Relief Fund website, available at https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/reportingauditing/index.html, funds must be expended no later than June 30, 2021. HHS will provide directions in the future about how to return unused funds. HHS reserves the right to audit Provider Relief Fund recipients now or in the future, and is authorized to collect any Provider Relief Fund amounts that were overpaid or not used in a manner consistent with program requirements or applicable law. All payment recipients must attest to the Terms and Conditions, which require the submission of documentation to substantiate that these funds were used for health care-related expenses or lost revenue attributable to coronavirus.
You can find recently updated Q&As by searching for ‘3/31/2021’ in the FAQ document. Please note, the FAQ document is updated regularly and there may be new information by the posting of this article. AAHomecare recommends recipients to continue to monitor the PRF website and email alerts from HHS on PRF. For specific questions, contact the PRF support line: (866) 569-3522.
CMS Starts AAP Program Recoupments
WASHINGTON, DC – For a short period early in the COVID-19 pandemic, CMS expanded its Accelerated and Advanced Payments (AAP) Program to Medicare providers and suppliers, including DMEPOS suppliers. The expanded program was available for DMEPOS suppliers starting March 28, 2020, and the suspension of the Program was announced a month later in April. According to CMS, more than 28,000 Part B providers and suppliers received a total of over $8 billion in advance payments through the expanded AAP Program.
However, unlike the funds from the Provider Relief Fund, payments from the AAP program are required to be repaid at the one year mark from the issuance date. For any outstanding balance after the one-year mark, CMS will begin recouping payments from the supplier’s Medicare claim payments. Supplier’s billing staff should be notified that recoupment will begin on or after the one year mark of the AAP issue date.
The recoupment process can take up to 17 months starting from the one year mark. Medicare will first automatically recoup 25% of the payments for the first eleven month period. Medicare will then increase it to 50% for the following six months. If supplier is not able to fully repay by the end of the six months, the DME MACs will send a letter to the supplier requesting repayment for the remaining balance within 30 days. If the supplier is unable to repay within 30 days, a 4% interest rate will be applied to the remaining balance.
Check the related MLN Matters article and CMS’ Fact Sheet for more information on the repayment process.