President Trump Signs into Law Continuing Appropriations Act, 2021 and Other Extensions Act

Legislative; COVID-19

This morning, President Trump signed into law H.R.8337: Continuing Appropriations Act, 2021 and Other Extensions Act. The Senate passed the bill last night by a vote of 84-10 and the House passed the same measure last week by a vote of 359-57-1.  

This continuing resolution (CR) provides continued FY2021 appropriations to federal agencies through December 11, 2020 and extends several programs. Of particular interest to our sector, this bill modifies the Accelerated and Advance Payment Programs under Medicare parts A and B during the COVID-19 pandemic. Below are specific details of the modifications. 

Congress changed the terms of loan repayment in the following ways: 

  • Subsection C of the bill makes clear that Part A providers, in addition to hospitals now have an extension from 120 days of the loan to 29 months from the date of the first payment. 
  • One year delay – Repayments for both Part A and Part B providers will not begin until at least a year from the date of the original payment from CMS. ​
  • Staggered recoupment – Rather than seizing the entire amount of claims until that is repaid, CMS would put limits on the total amount deducted from new claims during the recoupment period: 
    • ​During the first 11 months in which any such payment offsets are made, 25% of the amount is due. 
    • ​During the succeeding 6 months, 50 percent of the amount is due. 
  • ​​​Longer recoupment period – Providers would have 29 months from the date of the first Advance/Accelerated payment to repay funds before a bill is sent for the balance, including interest. 
  • Lower interest rate – The legislation would lower the interest rate for payments due after the recoupment period from ten percent to four percent.  
However, Congress is also sending a message back to CMS with the legislation. The CR would cap the total amount of funds CMS can issue through Advance/Accelerated payments under Part B to $10 million per year. The legislation also calls for additional reporting from CMS about the payments disbursed and tracking recoupment. Democratic committee leadership expressed concern with the fact CMS issued payments without Congressional input.