AMA Seeks Medicare Repayment Delay, HHS Extends Aid Deadline

Kerry Dooley Young

August 03, 2020

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The largest US physician organization asked federal officials to delay the start of repayments of Medicare money that was advanced earlier this year to clinicians to help them manage the financial shortfalls caused by the COVID-19 pandemic.

In a letter dated July 31, the American Medical Association (AMA) writes that some clinicians could see their Medicare reimbursement reduced by as much as 100% in a time of continued financial hardship under the current repayment terms.

Lawmakers have not yet cleared provisions needed to extend this deadline, but the Centers for Medicare & Medicaid Services (CMS) could do so on its own authority, James L. Madara, AMA's chief executive, writes in the letter.

CMS approved almost 24,000 applications totaling $40.4 billion in advance Medicare payments to physicians and other healthcare professionals in the early weeks of the pandemic. Current terms call for repayment to start 120 days after the advance was issued, which could be as early as the first week of August for some clinicians, according to AMA.

"This program offered an important lifeline for cash-strapped practices to weather financial hardships as a result of postponing and cancelling non-essential procedures to mitigate the virus and conserve personal protective equipment (PPE), as well as increased expenses in caring for patients with COVID-19 and with urgent and ongoing care needs," Madara wrote in the letter addressed to CMS Administrator Seema Verma.

But a sudden halt in cash flow would put practices in "financial jeopardy," Madara added.

"We believe it is reasonable to expect that physician revenues will continue to be reduced as COVID-19 cases are increasing, certain patients are unable or unwilling to leave home for an in-office service or procedure, and physicians will not be able to see nearly as many patients as they did before COVID-19 due to new safety precautions and PPE supply," he continued.

CMS did not immediately respond to Medscape's request for comment on the AMA letter.

Separately, on July 31, the Department of Health and Human Services (HHS) announced the extension to August 28 of the deadlines for clinicians to apply for a pool of federal aid.

This is the second extension of the deadline for physicians and other healthcare professionals who have many patients enrolled in Medicaid, Medicaid managed care, and the Children's Health Insurance Program.

In June, HHS announced plans to provide $15 billion to physicians who serve many patients enrolled in Medicaid, Medicaid managed care, and the Children's Health Insurance Program. Many of these clinicians were not able to apply for funds that had earlier been distributed to clinicians who see many patients enrolled in Medicare.

The initial deadline of July 20 for the Medicaid group was first extended to August 3. This group includes many pediatricians and obstetricians.

HHS also plans to allow a second opportunity for certain clinicians who see many people enrolled in Medicare to apply for funds. This new window for applications will open the week of August 10 and will close August 28, HHS said.

HHS distributed much of an initial $30 billion tranche of aid for this group earlier this year, pegging this aid to clinicians' levels of 2019 Medicare fee-for-service reimbursements.

This new window for applications will allow eligible clinicians who missed an earlier opportunity to apply for additional funding from the $20 billion portion of a $50 billion pool of aid known as Phase 1 Medicare General Distribution, HHS said.

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