CMS accelerates payments to physicians following Change attack

CMS is expanding its response to the cyberattack on UnitedHealth Group's Change Healthcare to include advance payments to physicians and other outpatient care providers experiencing claims disruptions.

The agency said March 9 it has made advance payments available to Medicare Part B suppliers experiencing significant operational challenges following the attack. The move follows HHS' March 5 announcement that it would help accelerate payments to hospitals and institute other workarounds.

"CMS recognizes that providers and suppliers may face significant cash flow problems from the unusual circumstances impacting facilities' operations, preventing facilities from submitting claims and receiving Medicare claims payments when using the Change Healthcare platform," the agency said.

The American Medical Association has said physician practices will face "significant financial disruptions" after Change shared that certain key functionalities will not be tested or fixed until March 18. One cybersecurity firm estimated that large health systems were bleeding more than $100 million per day because of the interruptions.

"The prospect of a month or more without a restored Change Healthcare claims system emphasizes the critical need for economic assistance to physicians, including advancing funds to financially stressed medical practices," Jesse Ehrenfeld, MD, president of the AMA, said in a March 8 news release shared with Becker's.

Change is expected to have its electronic payment platform available for connection on March 15 after a Feb. 21 "cybersecurity incident" that affected its nationwide healthcare connectivity and operations. As of March 7, the technology company's pharmacy electronic prescribing is fully functional for claim submission and payment transmission. Its medical claims network and software is expected to start testing for connectivity reestablishment March 18, with the company working throughout that week to restore the service. 

Medicare Part A and B providers experiencing disruptions can now apply for "amounts representative of up to 30 days of claims payments," which is based on the monthly average of total claims paid to a provider between Aug. 1 and Oct. 31, 2023, divided by three. Payments will be automatically recouped from Medicare claims over a period of 90 days, and "a demand will be issued for any remaining balance on day 91."

On March 1, Change set up funding assistance for providers facing cash-flow issues after losing access to its payer systems, which provider groups like the AHA have called insufficient. 

"We are committed to providing relief for people affected by this malicious attack on the U.S. health system," UnitedHealth CEO Andrew Witty said March 7. "All of us at UnitedHealth Group feel a deep sense of responsibility for recovery and are working tirelessly to ensure that providers can care for their patients and run their practices, and that patients can get their medications. We're determined to make this right as fast as possible."

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