Medicare Set to Begin Recoupment of Over $100 Billion of Advance Payments

March 26, 2021

In March of 2020, CMS expanded their Accelerated and Advance Payments Program to include Medicare Part A providers and Part B suppliers. The advance payments were sent out to help providers offset financial uncertainty due to COVID shutdowns and cancellations of elective medical procedures. The loan was based on the providers' request of up to 3 months of normal Medicare payment amounts. For the year, CMS advanced over $100 billion in payments and will soon begin the process of recouping these funds. 

The initial terms of these advanced payments required recoupment to begin 120 days after receipt of funds, but this was delayed with no further guidance in the early summer of 2020. The Continuing Appropriations Act, 2021, and other Extensions Act was enacted on October 1, 2020. In doing so, this amended the terms of the Medicare Advance Payments recoupment process. Your practice may have already received a letter from Medicare back in October informing you of when the process is scheduled to begin and its timeline for completion.
At any time, your repayment can be made in full by contacting your Medicare Administrative Contractor (MAC) (Listed below). If you already have done so then the repayment terms below will not apply.
According to the new guidelines, the recoupment process is as follows:

  • Repayment does not begin for one year starting from the date the accelerated or advance payment was issued.
  • Beginning at one year from the date the payment was issued and continuing for eleven (11) months, Medicare payments owed to providers and suppliers will be recouped at a rate of 25%. 
  • After the eleven (11) months end, Medicare payments owed to providers and suppliers will be recouped at a rate of 50% for another six (6) months.
  • After the six (6) month period ends, a letter for any remaining balance of the accelerated or advance payment(s) will be issued.

Click here to read the frequently asked questions.
Letter Requiring Reimbursement: Any provider who received a Letter Requiring Reimbursement is obligated to pay the full balance 30 days from the date on the letter. If payment is not made within the given time frame, an interest rate of 4% will accrue from the date of the letter and will continue accruing every 30 days until the balance is paid.
If you took advantage of the opportunity to receive a loan from the Accelerated and Advance Payments Program you will start to see a slight decline in your Medicare payments over the next year and a half until the advance is satisfied. There will be a webinar hosted by Medicare on this topic, if you would like to attend just click this link to sign up. If you have any questions, please contact your Practice Manager or reach out to your MAC directly via the information provided below.

MAC Contact Information
CGS Administrators - Jurisdiction 15 - 855-769-9920

First Coast Service Options Inc. - Jurisdiction N - 855-247-8428 

National Government Services - Jurisdiction 6 & Jurisdiction K - 888-802-3898 

Novitas Solutions - Jurisdiction H & Jurisdiction L - 855-247-8428

Noridian Healthcare Solutions - Jurisdiction E & Jurisdiction F - 866-575-4067 

Palmetto GBA - Jurisdiction J & Jurisdiction M - 833-820-6138 

Wisconsin Physician Services (WPS) - Jurisdiction 5 & Jurisdiction 8 - 844-209-2567 

Noridian Healthcare Solutions, LLC – DME A & D - A: 866-419-9458; D: 877-320-0390

CGS Administrators, LLC – DME B & C - B: 866-590-6727; C: 866-270-4909