CMS offers help for doctors and hospitals affected by Change outage

Politico Pro

March 5, 2024 2:26 pm

The Centers for Medicare and Medicaid Services on Tuesday said it will consider granting accelerated Medicare payments to affected doctors and hospitals on an individual basis, similar to a program that doled out $100 billion during the Covid-19 pandemic.

It’s one of several ways the agency will try to help doctors and hospitals devastated by the Change Healthcare cyber attack and comes a day after Senate Majority Leader Chuck Schumer called for accelerated payment approval.

Hospitals and physicians have complained of trouble receiving payments and, in some cases, of having little cash on hand because of the attack on UnitedHealthcare subsidiary Change Healthcare on Feb. 21, which runs the payment and processing systems for scores of health systems.

HHS did not return a request for comment on how much money is available for accelerated payments. The agency gave generous terms for repayments of accelerated payments for those affected by Covid-19, but it remains unclear if those same terms would apply for this round of funding.

CMS has also instructed independent Medicare contractors that process claims to expedite any provider’s request to change to a new processing platform.

The agency is also calling for Medicare Advantage and Medicaid-managed care plans to relax requirements for prior authorization, which requires doctors to get insurer approval before performing certain services or prescribing drugs. The outage has affected the ability of doctors and hospitals to submit such requests.

In addition, CMS is calling for independent Medicare contractors to make sure they can receive paper claims.

“While we recognize that electronic billing is preferable for everyone, the [contractors] must accept paper submissions if a provider needs to file claims in that method,” the agency said.