"In expanding the scope of eligible providers beyond what
"We are concerned by CMS's seemingly cavalier attitude toward the Trust Funds, in particular the decision to proceed with a
In the letter, the Democratic health leaders requested answers to a series of questions and a briefing to understand the impact of CMS's unauthorized expansion of the AAP program by
In May, Chairmen Neal and Pallone raised concerns over CMS's methodology for distributing COVID-19 loans from both the AAP Program and the
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To: The Honorable
Dear Secretary Azar and Administrator Verma:
We are writing to express our serious concerns regarding the
In the Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136),
To date, we have not received an adequate response from CMS.
Further, it has come to our attention that the Advance Payments Program, which provided Part B payments to Part A and B providers without Congressional authorization, resulted in a roughly
Additionally, we are bewildered by CMS's decision to use the
We have additional concerns regarding CMS's continued lack of communication and transparency with providers regarding when these payments are to be repaid. For providers, the terms of AAP require new Medicare revenue to be held in abeyance until the provider repays the amount in full. CMS has neither begun the recoupment process nor signaled to providers when it might do so. With little to no recent information from HHS about this program, AAP recipients are understandably anxious about their obligations to CMS and confused as to the timing.
While we anticipate providing statutory clarity around this issue in the Continuing Resolution, we are disappointed at the lack of communication to
In times as trying as these, the American people and our health care providers deserve as much certainty from all branches of the federal government as we are able to provide. To that end, please provide the following information and responses to our questions with respect to the AAP program by
1. Was the
2. The to-date and complete accounting for AAP funds distributed from the HI and SMI Trust Funds, including any repayments received from AAP eligible entities.
3. The to-date and complete accounting of any funds borrowed from the
a. Did the agency conduct any legal analyses on whether it would be permissible to make payments to Part A providers on their Part B claims from the
4. Information on any future changes CMS intends to make to AAP eligibility, payment amounts, and/or repayment terms, and whether the Administration intends to resume making new payments under the AAP program as expanded by the CARES Act and CMS6 during the COVID-19 public health emergency.
5. The processes the agency intends to undertake for repayment of AAP payments, including specific processes for recouping/reconciliation and notifying providers of recoupment deadlines and obligations.
6. A list of all providers who have received payments, and the dates that such payments were made. Such list should include for each provider or supplier:
a. Whether the payment was made through the Advance Payment Program or Accelerated Payment Program;
b. The providers' CMS certification number or other appropriate number;
c. The amount of the payment to each provider or supplier;
d. Information on the total percentage of applicable claims over the applicable period that the loan represents;
e. Information on the status of any repayment or recoupment of AAP via Medicare payment offsets currently underway;
f. Whether the provider or supplier is eligible to receive additional payments through either program; and
g. Whether the provider or supplier has received funding through the
We look forward to receiving this information so that we can conduct the business the American people expect of us.
Richard E. Neal, Chairman,
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1 Letter from Rep.
3 Letter from Rep.
4 See note 3.