CMS Confirms Longer Repayment Terms for Medicare Advances, Offers Further Extensions

The Centers for Medicare & Medicaid Services (CMS) confirmed the extension by more than two years of repayment terms for advance Medicare cash floated to providers, while also offering further relief of up to five years for operators in particular financial distress.

Under the more generous terms, passed earlier this month as part of a continuing resolution designed to avert another federal government shutdown, operators who participated in the Medicare Accelerated and Advance Payment Program (AAP) will have up to 29 months before the government begins to recoup the funds.

Launched in late March, the AAP allowed operators to access up to three months’ worth of future Medicare payments in advance. CMS would then begin recouping the funds from future reimbursements within 120 days.


All repayment will now be delayed for a year, with 25% of Medicare reimbursements after that date automatically withheld to repay the advance amounts for 11 months; that figure will increase to 50% for the subsequent six months.

“If the provider or supplier is unable to repay the total amount of the AAP during this time period (a total of 29 months), CMS will issue letters requiring repayment of any outstanding balance, subject to an interest rate of four percent,” CMS noted.

Those letters will also allow operators that “are experiencing financial hardships” to apply for an Extended Repayment Schedule (ERS), which can delay recoupment for three to five years; providers can also reach out proactively to their Medicare Administrative Contractor (MAC) to learn more about the extensions.


In all, CMS floated $98 billion to Medicare Part A providers under the AAP. The figures come on top of the billions in CARES Act stimulus funding that health care operators have received; CMS clarified that companies can use that money to repay their advance Medicare payments if necessary.

“In the throes of an unprecedented pandemic, providers and suppliers on the frontlines needed a lifeline to help keep them afloat,” CMS administrator Seema Verma said in a statement. “CMS’ advanced payments were loans given to providers and suppliers to avoid having to close their doors and potentially causing a disruption in service for seniors. While we are seeing patients return to hospitals and doctors providing care we are not yet back to normal.”

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