May 15, 2020

Cortez Masto, Rosen Cosponsor Legislation to Improve Medicare Payments Program and Provide Financial Relief for Health Care Providers on Frontlines of Coronavirus Pandemic

Washington, D.C. – U.S. Senators Catherine Cortez Masto (D-Nev.) and Jacky Rosen (D-Nev.) joined Senators Jeanne Shaheen (D-N.H.) and Michael Bennet (D-Colo.) in introducing legislation to make improvements to Medicare’s Accelerated and Advance Payments Program. This program was expanded under the Coronavirus Aid, Relief, and Economic Security (CARES) Act to allow for hospitals, physicians and other Medicare-participating providers to apply for upfront payments from Medicare to help cover revenue shortfalls as a result of COVID-19. Across the nation, this program has delivered more than $100 billion in loans to health care providers, providing a reliable and stable cash flow to help them maintain and support an adequate workforce, buy essential supplies, and keep their doors open to care for patients.

To protect providers from unreasonable repayment terms during this pandemic, the Medicare Accelerated Advance Payment Improvement Act would reduce interest rates and modify repayment obligations for health care providers who have sought financial assistance amid the coronavirus pandemic under this program. Representatives Brad Schneider (D-Ill.-10) and Ron Kind (D-Wis.-03) will introduce companion legislation in the House.

“Nevada’s health care providers have been working overtime to care for patients and keep our communities healthy,” said the Senators. “These changes to Medicare’s Accelerated and Advance Payments Program will ensure that hospitals, clinics, and other medical providers who rely on this program as a vital funding source have the stability they need to continue to provide top-quality care to Nevadans in need, without being forced to close their doors when the bill comes due. We’ll keep fighting in the Senate for common-sense policies that support our health care providers and all those on the front lines of this pandemic.”


Rather than allowing a gradual repayment, the program currently requires the Centers for Medicare and Medicaid Services (CMS) to withhold 100 percent of otherwise applicable payments owed to providers for Medicare services in order to pay back the upfront payment, starting as soon as just four months after the upfront payment is made. Equally concerning, if these upfront payments are not recouped within certain timeframes (e.g. within a year for hospitals) after the upfront payment was made to the health care provider, CMS is required to charge significant interest on the remaining balance owed by the provider. Based on current Treasury regulations and rates, the applicable interest rate is set as high as 10.25 percent for repayment of Medicare’s accelerated and advance payments for hospitals, physicians and other health care providers who have not completed repayment by the applicable due date.

This legislation would delay the start of the withholding period and the commencement of interest accrual, while also limiting the portion of Medicare reimbursement for services that can be withheld to pay down the upfront payment to 25 percent of the otherwise applicable payment for the service. The bill would limit the interest rate to 1 percent for remaining balances that have not been paid back through withholding after two years. The legislation would also authorize CMS to forgive remaining balances owed by providers in cases of hardship. To help ensure that the Medicare Accelerated and Advance Payments Program does not harm Medicare’s solvency or Medicare premiums, the bill requires the Department of the Treasury to work with CMS to hold the Medicare trust funds and Medicare premiums harmless.

The legislation is supported by the American Medical Association, America’s Physician Groups, and the Federation of American Hospitals.