Change Healthcare Cyberattack – What it Means for Your Organization

Change Healthcare’s February 21, 2024, cyberattack has resulted in many organizations experiencing an inability to verify patients’ insurance coverage, a lack of access and ability to share critical health records, delays in billing and, ultimately, cash shortages due to the aforementioned issues.

While the full impact of this cyberattack is unclear, affected organizations may submit requests for accelerated payments. Official guidance on the specifications of the requests has been made available as early as March 9^th by the Medicare administrative contractors (MACs). The eligibility requirements and links to the applications, by MAC, have been included below. If your organization is impacted, we encourage you to begin compiling data to expedite the application process.

Eligibility requirements

• Requests will be for individual provider numbers (National Provider Identifier [NPI] and Medicare ID [PTAN]).
• Providers receiving periodic interim payments are NOT eligible.

Links:

• Noridian Healthcare Solutions
• Novitas Solutions
• WPS Government Health Administrators

CMS has also issued guidance to the MACs on flexibilities to help alleviate the initial burden on impacted organizations. A summarized list follows:

• The MACs are instructed to expedite requests to change to a new electronic data interchange (EDI).
• Guidance will be issued to Medicare Advantage and part D payors to relax prior authorization, utilization management, and timely filing requirements.
• CMS has encouraged Medicare Advantage plans to offer advanced funding options, but you will need to check with each of your payors to determine eligibility.
• Medicaid and CHIP managed care programs will also be encouraged to offer the same relaxed requirements for prior authorization, utilization management, and timely filing requirements. They are also encouraged to consider offering advanced funding to providers.
• Impacted organizations are encouraged to contact their MAC or CMS for exceptions, extensions, or waivers relating to delays in claims filing, notices, or submissions.
• The MACs will be prepared to accept paper claims where necessary.

As always, your knowledge and preparedness is our primary goal. Navigating situations like a cyberattack can feel uncertain, so feel free to contact us or reach out to your DZA representative with any questions or concerns.

– Shayna DesJardin, CPA
Senior Manager