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Legal Insights and Perspectives for the Healthcare Industry

The Centers for Medicare & Medicaid Services (CMS) announced on April 26 that it will no longer be accepting new applications for the Medicare Accelerated/Advanced Payment Program (AAPP).

CMS made the decision despite Congress’s direction in Section 3719 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act that the US Department of Health & Human Services “shall expand the [AAPP]” by eliminating certain eligibility prerequisites to applying for the temporary cash assistance offered by the program. According to CMS, it “will be reevaluating all pending and new applications for Accelerated Payments in light of historical direct payments made available through HHS’s Provider Relief Fund.” For more information on the AAPP, please see our recent LawFlash and blog post.

Though Congress gave no indication that the AAPP would be limited during the coronavirus (COVID-19) public health emergency by providers’ participation in the other relief funds made available in the CARES Act, CMS decided to “reevaluate” amounts that it will be paying under the AAPP “in light of the $175 billion recently appropriated for healthcare provider relief payments.”

Emphasizing its grant relief funding from direct congressional COVID-19 appropriations, CMS apparently believes that additional cash infusions to providers via the AAPP’s temporary loans are no longer necessary. CMS offered no indication that the elimination of the AAPP was part of safeguards it was adopting to address “fraud, waste, or abuse,” which Congress expressly provided as the limiting factor to its otherwise broad instruction that CMS “shall provide accelerated payments under the program to such [eligible] hospital[s].”

Providers already approved to participate in the AAPP do not appear to be affected by CMS’s decision, while providers that have completed the application process with their Medicare Administrative Contractors (MACs) and are awaiting determination may be subject to a discretionary agency decision on their need for the funds, rather than the rubber-stamped approval previously contemplated.