QUESTION: We have received letters indicating when repayment of Advanced Payments will begin. Has Medicare released anything on exactly how that will work and how the remit will look? Will there be specific CARC or RARC codes used? Thanks!
MGMA REPLY:
Thanks for posting this question! Earlier this month, CMS announced the details of Medicare Accelerated & Advance Payment (AAP) recoupment, which are consistent with legislation passed by Congress in September:
“Providers were required to make payments starting in August of this year, but with this action, repayment will be delayed until one year after payment was issued. After that first year, Medicare will automatically recoup 25 percent of Medicare payments otherwise owed to the provider or supplier for eleven months. At the end of the eleven-month period, recoupment will increase to 50 percent for another 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.”
Regarding remits, CMS indicates in its AAP FAQ, “Providers and suppliers will see the offset amount reflected on their Remittance Advice. Providers and suppliers should contact their MAC to receive current balance and payment information related to the repayment of their AAP payment.” I have not yet seen specifics around which codes will be used on the remits. However, the Agency plans to issue further information on the recoupment process at a later date, and the details of these adjustment codes may be covered in future guidance.
Please let me know if I can provide any further clarification!
Best,
——————————
Matt Devino
Associate Director, Government Affairs MGMA
Washington DC
——————————