CMS Announces Flexibilities in the Wake of the Change Cyberattack

Change Healthcare

Federal officials have announced several flexibilities to help physicians in the wake of the cyberattack against Change Healthcare which upset payment and revenue cycle management operations for practices across the country.

Saturday, March 9, the Centers for Medicare & Medicaid Services (CMS) announced an accelerated avenue of assistance for impacted practices which includes requesting advanced Medicare payments.

Details can be found in this CMS fact sheet.

Change Healthcare had issued a statement that it expected “to begin testing and reestablish connectivity to our claims network and software on March 18, restoring service through that week.”

CMS has instructed Medicare Administrative Contractors (MACs) to accept paper claims from physicians who need to use them, and to expedite physician requests to switch to new clearinghouses to work around the Change Healthcare outage. Paper claims processing requires a minimum 29-day payment floor, which means payment cannot be released before the 29th day following receipt and there is no automated editing for claim errors as there is with electronic billing, so if a paper claim form contains mistakes, the Medicare contractor will have to return the claim to the physician to make corrections for resubmission.

CMS has approved a waiver of those requirements for those impacted by the Change Healthcare cyberattack. To request the waiver, physicians can complete the ASCA Waiver Request form.

CMS also said it will issue guidance encouraging Medicare Advantage (MA) plans and Part D sponsors to remove or relax prior authorization, other utilization management, and timely filing requirements. CMS is also encouraging MA plans to offer advance funding to health care professionals most affected by the cyberattack.

Caroline Fife, MD

Dr. Fife is Co-Founder and Chief Medical Officer of Intellicure, Executive Director of the US Wound Registry, and Editor of Today’s Wound Clinic.

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