Overpayments

Accelerated and Advanced Payment Program

COVID-19 Accelerated/Advanced Payment Revised Repayment Terms

On 3/28/2020, CMS expanded the existing CAAP to a broader group of Medicare Part B Providers.

The CMS CAAP Program was established to increase case flow to Medicare providers and suppliers impacted by the 2019 Novel Coronavirus (COVID-19) PHE. These payments were funded from the Supplementary Medical Insurance (Part B) Trust Funds, which are the same funds used to pay Medicare claims each day. CAAPs are advances on claims payment amounts that providers and suppliers were instructed to pay back.
Beginning 6/28/2021, CMS will publish repayment data and update it every six months.

Medicare Accelerated and Advance Payments Program COVID-19 Public Health Emergency Payment Data

The Continuing Appropriations Act, 2021 and Other Extensions Act amended the repayment terms for the COVID-19 accelerated/advance payments. The changes to the repayment terms are listed below:

  • If volunteer payment was not sent, automatic recoupment will begin one year after the date the accelerated or advance payment was issued.
  • During the first 11 months after repayment begins, the recoupment rate will be 25% and repayment will occur through an automatic recoupment of the provider/supplier Medicare payments.
  • At the end of the 11-month period, the recoupment rate will increase from 25% to 50%. The automatic recovery at the 50% recoupment rate will continue for six months.
  • If the total amount of the accelerated/advance payment is not recovered within 29 months from the date the payment was made, a demand letter for the outstanding balance will be issued. The demanded amount will be subject to a 4% interest rate.

When recouped, the CAAP offets related to the COVID-19 Public Health Emergency will be reported on the remittance advice with “CVD”.

Affiliated providers: Any/each related provider (same Tax ID) to the PTAN that received the CAAP will each offset 25% of the total RA amount. Any affiliate PTANs will offset 25% of their remaining amount on their RA after any regular AR or ERS offsets are made. CMS is looking at the Tax ID to get the recoupment from the advanced payment regardless of which PTAN actually received the payment. More information on affiliated provider recoupment is available on our website within the Overpayments tab Nettings/Offsets Across Organization Affiliations.

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Reviewed 10/17/2024