Core Concepts
Efforts to expedite payments for providers affected by a cyberattack.
Abstract
The Centers for Medicare and Medicaid Services (CMS) have initiated a program to assist physicians and hospitals impacted by a cyberattack on Change Healthcare's EDI clearinghouse. The relief efforts aim to expedite payments and provide financial support to healthcare providers facing disruptions in claims processing and reimbursement due to the cyberattack.
CMS introduces a program to speed up payments for providers affected by the cyberattack.
Change Healthcare's EDI clearinghouse offline since February 21 due to ransomware attack by hacker group AlphV/BlackCat.
Federal authorities and UnitedHealth Group (UHG) announce initiatives to support providers during system restoration.
UHG offers interest-free cash advances through Optum Financial Services based on prior claims volume.
Industry associations call for more robust government response to aid healthcare providers.
CMS details a plan for accelerated payments to providers experiencing claims processing delays.
Providers can request advance payments representing up to 30 days of claims payments.
Repayment will be made over 90 days through automatic recoupment from Medicare claims.
Medicaid providers also affected, urged to consider prospective payments from managed care plans.
UHG working towards system restoration, with some operations expected to resume by March 15.
Stats
"The disruption affected pharmacy operations and providers' ability to receive payer reimbursements, file electronic claims, and verify eligibility."
"The loan amount, which must be repaid, is based on average prior claims volume and how much a provider's payment distributions have been affected."
"Christine Meyer, MD, said her practice's daily insurance reimbursements dropped from $70,000 to the lowest ever — just $1600."
"The expedited payment amount is calculated using the monthly average of total Medicare claims paid between August 1 and October 31."
"Repayment will begin immediately, with funds repaid in full over 90 days through automatic recoupment from Medicare claims."
Quotes
"My practice is losing $500,000 in charges each month, and we were offered a $4000 (per month) loan." - Christine Meyer, MD