CMS extends dispute process amid Change hack

In response to the February ransomware attack on Change Healthcare, CMS is introducing special measures to assist affected organizations in navigating the federal independent dispute resolution process under the No Surprises Act.

In a June 14 news release, CMS reported receiving numerous complaints from healthcare providers, facilities and air ambulance services about difficulties in initiating open negotiation. These challenges are due to disruptions in receiving necessary payment information and disclosures from plans or issuers caused by the Change Healthcare cybersecurity incident, which has significantly delayed claims processing.

To address these issues, CMS designated a special period for affected organizations. These entities can initiate open negotiation for any service provided on or after Jan. 1 at any time from June 14 to Oct. 12. This special period applies regardless of when they received payment or denial notices.

To utilize this special period, parties must submit an attestation form along with the standard open negotiation initiation form, certifying that the incident impacted their ability to start open negotiation.

During this period, parties do not need to request individual extensions via the federal IDR inbox as previously required. Instead, IDR entities will handle disputes about eligibility during their review process. Parties that disagree with the eligibility should provide supporting documentation during open negotiation and to certified IDR entities, according to CMS.

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