Coronavirus Update #175
CMS Guidance on Medicare Accelerated and Advance Payment, MDH Webinar Recap, Voting Guide, Power Wheelchair Update, Additional Reminders
CMS Releases Medicare Accelerated and Advance Payment Guidance 

Yesterday, the Centers for Medicare and Medicaid Services (CMS) released updated Medicare Accelerated and Advance Payment guidance based upon the recently enacted Continuing Appropriations Act, 2021 and Other Extensions Act. 

The CMS guidance outlines the following repayment schedule: 

  • Repayment does not begin for one year starting from the date the accelerated or advance payment was issued (e.g., the date a SNF received its payment); 

  • Beginning at one year from the date the payment was issued and continuing for 11 months, Medicare payments owed to providers and suppliers will be recouped at a rate of 25 percent; 

  • After the 11 months end, Medicare payments owed to providers and suppliers will be recouped at a rate of 50 percent for another six months; and 

  • After the six months end, a letter for any remaining balance of the accelerated or advance payment(s) will be issued. 

If such a letter is issued, SNFs will have 30 days from the date of the letter to repay the balance in full. If payment is not received within 30 days, interest will accrue at the rate of 4 percent from the date the letter was issued, and will be assessed for each full 30-day period that the balance remains unpaid. Information related to Extended Repayment Schedules will be included in these letters. CMS may immediately issue these letters to SNFs who received accelerated or advance payments in error. 

In a departure from previous policy, CMS notes that SNFs can submit one or more lump sum payments to pay off all or some of their total balance. To arrange a lump sum payment, CMS indicates SNFs should contact their MAC(s) for more instructions on how to make a lump sum payment, especially if payment will be made after the repayment timeframe begins.  

For questions related to the Accelerated and Advance Payment Program, CMS has established COVID-19 hotlines at each MAC that are operational Monday through Friday to assist all providers with accelerated or advance payment concerns. Providers can contact the MAC that services their geographic area(s). To locate designated MAC areas, refer to the MAC Contact section of this document or visit the MAC website list

For More Information: The CMS Factsheet is located here and the FAQ document is located here.  
MDH Webinar Recap

Yesterday, the Maryland Department of Health held a webinar call to update the long-term care sector on COVID-19 developments and best practices. The call was recorded, in case you were unable to join or would like to review the topics discussed, which included:

  • Review current situation of COVID-19
  • COVID-19 Epi Updates
  • MDH Updates
  • CDC Updates
  • Influenza Vaccination
  • POC Testing Guidance
  • Q&A

You can also view the webinar's Powerpoint presentation here.

If you have any questions, please email
2020 Voting Guide
The 2020 General Election is Tuesday, November 3. Make sure that residents, patients, and staff are prepared to vote. Check out this voting guide for deadlines and information on voting.

Important Deadlines:
  • Make sure to register by Tuesday, October 13.
  • Vote by mail requests must be received by Tuesday, October 20.
  • Ballots must be postmarked or hand delivered by Tuesday, November 3.
Power Wheelchair Update

Last week, the Office of Long Term Services and Supports issued Nursing Home Transmittal No. 275, which discusses the Department’s plan to move processing of power wheelchair requests for nursing facility residents effective November 1, 2020.  Beginning that date, requests for power wheelchairs will be accepted only when:

  1. Submitted to Telligen, the Maryland Medicaid Program’s Utilization Control Agent, via the online Qualitrac 3.0 portal; and
  2. Submitted by a durable medical equipment (DME) supplier who is an enrolled Maryland Medicaid DME provider and has an account with Telligen.

The Program has many DME suppliers enrolled as Medicaid providers. Please check with your DME supplier to ascertain if it is an actively enrolled Maryland Medicaid provider.

If your current supplier is not an enrolled Maryland Medicaid DME provider, please encourage them to begin the process for applying for a Medicaid provider number by submitting an application to the Program’s ePREP portal

Finally, please note that even though the DME providers will now be requesting the authorization, nursing facilities will continue to file the claim for the approved amount using revenue code 0947.

We appreciate your cooperation and patience during this transition. If you have any questions, please feel free to contact Faith Terrell at  
Additional Reminders
HHS Update to Provider Relief Fund FAQs

The Department of Health and Human Services recently updated the Provider Relief Fund (PRF) FAQs with Phase 3 information. Several of the FAQs also provide helpful insights into other PRF requirements. AHCA/NCAL has developed a summary of these updates. 
Pay For Performance Changes

The 2019 Joint Chairmen's Report (JCR) requested the Maryland Department of Health to submit a plan to make the following modifications to its P4P program:

  • Increase the size of the total award from 0.5 percent to 1.0 percent of the total nursing facility provider reimbursement;
  • Refocus the program on reportable resident outcomes; and
  • Include incentives and disincentives.

In order to address the requirements of the JCR, MDH convened a workgroup (which included HFAM, providers, and other stakeholders) to review and recommend updates to the P4P model. The workgroup focused on each of the quality measures as well as on the calculation of the total award and the distribution of the award. As a result of the workgroup's review and recommendations, the Department has made modifications to the P4P model.

MD Think Updates and Training

As we previously shared, a new MD Think update is scheduled for release on Tuesday, October 13, 2020. There will be a weekly training hosted by the MD Think team every Thursday from 1:00 - 3:00 PM. Click here for a memo from MDH with more details on the changes and training.

Decommission of the Office of Long Term Care Dedicated Email Account: Beginning Tuesday, December 1, 2020, DHS will decommission the Office of Long Term Care ( dedicated email account that some facilities use to submit applications, redeterminations or documentation. Click here for the memo from MDH for more information.
CRISP Monthly Webinar Series: Understanding ENS PROMPT Filtering for Transitions of Care

Last month CRISP discussed the ENS PROMPT application and how it provides near real-time event notifications when your patient has a hospital encounter, receives COVID-19 test results, and much more. This month, the focus is on a very specific and beneficial functionality within the ENS PROMPT tool - filtering. Filtering helps ensure that you are viewing the most pertinent and relevant notifications to drive more effective and efficient transitions of care.

Join CRISP Wednesday, October 14, 2020 at 12:30 p.m. for a discussion on the basics of CRISP ENS PROMPT filtering followed by a deep dive into what those filters actually mean and how they can best support healthcare professionals.
While webinars are open to all CRISP users, this presentation may be most beneficial to those who are actively utilizing ENS PROMPT or those interested in learning more about maximizing the use of the filters provided.
Indoor Visitation Explainer for Families

Along with our partners at LeadingAge Maryland and Lifespan, we wanted to share this quick guide to help families understand the full scope of what “indoor visitation” resuming really means. Please feel free to share this document with your teams, families, and communities.
Flu Shot Resources

People who are 65 and older are at high risk of having serious health complications from the flu. Now more than ever, everyone needs to do their part to prevent the spread of illnesses like the flu. Getting a flu vaccine is a simple, easy, and powerful way to protect your health and the health of those around you.

Medicare covers the cost of the flu shot, which is available at most health care provider offices, local pharmacies, senior centers, health centers, and other places in the community.

This year, CMS is developing many new flu vaccination resources for people with Medicare, partners, providers, and others who can share our message.

Consumer Resources on

Partner & Provider Resources on
  • CMS developed a new page – – for one-stop shopping to help you find CMS’s flu vaccination information and resources.
  • Visit the Outreach & Media Materials page for flu vaccination materials you can share within your partner networks and use to reach people with Medicare, plus other audiences across our health care programs. We will continue to update this page with additional resources.
  • Use this social media toolkit with posts and graphics to spread the word about the importance of getting a flu shot this year (in English & Spanish).
  • For partners, CMS launched a Flu Vaccine Partner Toolkit with flu and other immunization resources. Multi-language fact sheets and much more here!
  • For health care providers, CMS launched a new website – – with flu coverage and billing information.
Did you miss HFAM's previous alerts?

Visit our website to view all previous HFAM alerts, as well as guidance
from our federal and state partners.
Thank you.

We cannot thank you enough for the dedication and diligence in doing all that you can for the residents in your communities. HFAM continues to monitor the COVID-19 pandemic with our state and national partners and will do all we can to support you during this time.