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CMS Recoupment of Medicare Advanced Payments Began March 30  

For CEOs, CFOs, government relations staff

Claims recoupment for providers that received a Medicare Advanced and Accelerated Payment (AAP) will begin on the one-year anniversary from the date the provider received the payment. The Centers for Medicare & Medicaid Services (CMS) recently announced that the earliest recoupments for the first providers to receive an AAP payment began on March 30.

In accordance with the Continuing Appropriations Act of 2021, the repayment of AAP funds will occur based on the following schedule:

  • Repayment begins one year from the date CMS issued the first AAP.
  • Beginning one year from the date the AAP was issued and continuing for 11 months, CMS will recover the AAP from Medicare payments due to providers and suppliers at a rate of 25%.
  • After the end of this 11-month period, CMS will continue to recover remaining AAP from Medicare payments due to providers and suppliers at a rate of 50% for six months.
  • After the end of the six-month period, a provider’s Medicare administrative contractor (MAC) will issue a demand letter for full repayment of any remaining balance of the AAP.

If CMS doesn’t receive payment within 30 days, interest will accrue at the rate of 4% from the date of the MAC demand letter. Interest will be assessed for each full 30-day period that the balance remains unpaid.

CMS will show the recoupment on the remittance advices issued for Medicare Part A and B claims processed after the one-year anniversary of issuing the first payment. The recoupment will appear as an adjustment in the Provider-Level Balance section of the remittance advice.

Institutional providers who receive Periodic Interim Payments (PIP) will have payments re-couped from the PIP.