Dozens of hospitals signed a recent letter to Congress asking, among other things, for more time to repay their accelerated Medicare loans.
Some of those hospital companies, however, had already repaid the money, and even those that haven't don't anticipate needing to pay the 4% interest that gets tacked on once the initial repayment periods end.
Of the $107.3 billion the Centers for Medicare and Medicaid Services distributed to healthcare providers and suppliers under the COVID-19 Accelerated and Advanced Payments Program, the agency recouped 53% by the end of November. That includes 55% of the $98.8 billion distributed to Part A providers, mostly hospitals, and 28.7% of the $8.5 billion distributed to Part B providers and suppliers, mostly medical groups.
Healthcare finance experts say most hospitals and health systems have carefully accounted for the accelerated Medicare payments and won't have problems shouldering the repayments, which automatically come out of their Medicare reimbursements.
"I've had some clients pay it off entirely right around the time recoupment started, so they haven't had to deal with this," said Aparna Venkateswaran, senior manager with Moss Adams. "Those providers that were anticipating this and trying to plan for it, it's not really going to impact them because they've incorporated it into their cash flow analysis."
The hospital industry has more pressing needs it wants the government to address, such as delaying scheduled Medicare reimbursement cuts, getting additional Provider Relief Fund dollars as COVID-19 continues to batter them and reinstating 340B eligibility for facilities that fell out of the program during the pandemic.
"Even though we got money in 2020, 2021 was harder and more intense than anything we've ever seen," ProMedica CEO Randy Oostra said.
Nevertheless, hospitals—both on their own and through their powerful lobbying arms—are asking Congress to halt advance payment collections for six months. After that, they want recoupment to account for just 25% of their Medicare claims for the following year.
"It's really a cash flow issue and a cash flow crunch," said American Hospital Association CEO Rick Pollack. "We're still dealing with the pandemic. We're simply asking that, once again, we change the payment schedule to provide us with more relief and flexibility."