Medicare Delays Repayment Period for AAP Loans

Medicare providers who received an advance payment under the Accelerated and Advance Payment (AAP) Program now have more time to repay these loan funds, under revised payment terms from CMS.

The AAP allowed CMS to make advance payments to providers at the height of the COVID-19 pandemic, distributing more than $98 billion to health care providers to help relieve the financial burden and cash flow disruptions caused by the pandemic.

Repayment, which was originally due to begin in August, will now begin one year from the payment issuance date. At that time, Medicare will withhold 25% of Medicare payments for 11 months. After 11 months, this withholding will increase to 50% for 6 more months. Any outstanding balance after this time will incur a 4% interest rate.

This timeframe gives providers up to 29 months total to repay the funds interest-free. Remember, payments received from the Provider Relief Fund (PRF) under the CARES Act may be used to repay these Medicare loans.

AAP recipients who continue to experience financial hardships can request an Extended Repayment Schedule (ERS). This installment payment plan allows for repayment terms over the course of 3-5 years.

If you received an AAP accelerated payment, CMS will be communicating with you soon on your specific repayment terms and amount owed. If you have any questions about these terms or allocating PRF funds for this purpose, please contact your Grassi advisor or our Emergency Loan Consultants on our Crisis Response & Recovery hotline.


John V. Pellitteri John V. Pellitteri is a Partner at Grassi and leads the firm's Healthcare and Cannabis Service Practices. Possessing over 30 years of experience in accounting, auditing, tax planning and business consulting, John is now applying his talent to the burgeoning cannabis industry. John possesses comprehensive accounting and taxation knowledge, which combined with his healthcare consulting experience, allows him to provide an all-inclusive assessment of... Read full bio

David M. Rottkamp David M. Rottkamp, CPA, is an Audit Partner and Nonprofit Practice Leader, at Grassi. David has over 36 years of experience providing audit and advisory services to the not-for-profit and health care industries. David focuses on organizations serving individuals with special needs, religious organizations, educational institutions, membership associations, social service providers, healthcare providers, foundations, and the arts and culture world. David’s technical knowledge allows... Read full bio

Joseph Tomaino Joseph Tomaino is the Chief Executive Officer of Grassi Healthcare Advisors, LLC and has nearly 40 years of healthcare management experience working in the not-for-profit, for-profit and government-sponsored segments. As a chief executive officer, chief nursing officer, consultant, and educator, Joseph has worked with provider organizations and payers across the U.S. as an architect of value based care -- improving clinical effectiveness along with... Read full bio

Bruce C. Levine Bruce C. Levine, CPA, MST is a Partner Emeritus at Grassi and former leader of the firm’s Needham, MA office. He specializes in financial management, strategic business planning and tax planning for closely held businesses, professional service providers and high-net-worth individuals. With more than 40 years of experience in public accounting, Bruce has advised clients in a wide range of business sectors, with a... Read full bio