While the Centers for Medicare & Medicaid Services has started a advanced payment program For Part A and Part B providers experiencing claims disruptions due to the Change Healthcare cyberattack two weeks ago, states are also providing relief to providers affected by the breach by reducing claims system payment roadblocks and to provide financial support.
WHY IT MATTERS
The state government in Washington is also offering similar advanced payment relief through its Medicare and Medicaid programs, although organizations like the American Hospital Association previously raised concerns about CMS’ reimbursement terms and interest rates.
On Tuesday, the Evergreen State Department of Health and Human Services directed its Medicare Administrative Contractors to make upfront lump-sum payments based on historical payment volumes for Medicare claims, according to the Washington State Hospital Association.
“The amounts advanced will later be recovered from paid claims,” WSHA wrote in a new online support resource page it was launched with the AHA.
“This program should benefit hospitals and health care providers in cases where a large portion of their Medicare reimbursement for services has been disrupted. This program is for Medicare reimbursement for services only and does not apply to Medicare Advantage or other payers. “
Meanwhile, New Mexico is using its insurance regulatory structure to ease pressure on health care, including telehealth. State Insurance Superintendent Alice Kane issued an order on March 20 to protect small health care practices in response to the Change Healthcare cyberattack.
“Most notably, the cyberattack has made it difficult and in some cases impossible for physicians to receive payment for the health care services they provide to New Mexicans,” said Anne Jung, executive director of the New Mexico Medical Society. bulletin.
Jung noted that the measures are aimed at “alleviating the pain points that small and independent practices have experienced as a result of the nationwide collapse of interconnected systems.”
The order directs health insurers overseen by Kane’s office to temporarily suspend prior authorizations, refrain from retroactively denying claims due to “common issues caused by the cyber incident” and to see deadlines submitted by small and independent providers that occurred after the February 21 attack.
Payers are also being asked to suspend policies that require providers to submit claims within a certain time frame after services are provided.
On the East Coast, the Maryland Department of Health has made more than 500 advance payments to health care providers to keep medical offices operational and help health care providers pay their bills and employees. WYPR News.
Although it is not yet listed among the agency’s Change Healthcare Cybersecurity Incident Updates sources pagesaid Sara Barra, chief of staff for behavioral health at MDH story that there is a dedicated state email account to respond to requests for assistance from individual providers.
“If it’s advance payments to help make payroll, if it’s technical assistance in changing their clearing house, we want to help,” Barra said.
THE BIG TREND
UHG said on Friday it would start restoring Change’s main platforms and processing claims. However, 11 systems are scheduled to be restored from the week of March 25 through the week of April 8, according to a product restoration timeline posted on its website. incident response information.
Modification claim preparation went back online on March 18, the company also said, estimating that it has $14 billion worth of claims ready. While representatives from provider industry groups have mocked the aspects of relief and its effect on providers in recent weeks, UHG said it has provided more than $2 billion in temporary financing assistance to providers.
AHA has also urged the government for additional funding.
Most recently, the organization asked Congress in a March 20 letter to “address any regulatory limitations that prevent (CMS and HHS) from adequately assisting hospitals and other health care providers affected by the Change Healthcare cyberattack” in fiscal year 2025 . Services budget, according to a website rack.
ON THE RECORD
“I don’t understand why more people aren’t yelling and screaming,” Gene Ransome, the CEO of the Maryland State Medical Society, told Maryland’s local news. “This is a major risk to our entire health care system.”
“I want to thank New Mexico’s major health insurers for the important steps already taken to help providers resolve issues arising from this cyber incident,” Kane, the state’s top insurance regulator, said in a statement last week.
Andrea Fox is editor-in-chief of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.