The Centers for Medicare & Medicaid Services (CMS) is actively addressing the challenges faced by healthcare providers in the wake of the cyberattack on UnitedHealth Group’s Change Healthcare subsidiary. In a recent roundtable with senior Administration leaders, CMS Administrator Chiquita Brooks-LaSure emphasized the urgency of the situation and urged health insurers to enhance their support for affected providers and suppliers. This proactive approach highlights the critical role of various health care programs in ensuring stability and continued access to care during disruptive events.
Recognizing the widespread impact, particularly on Medicaid providers, CMS announced forthcoming guidance for states. This guidance aims to provide states with the flexibility needed to support their Medicaid providers and suppliers, especially those operating within fee-for-service systems. Many Medicaid providers are experiencing significant strain due to the cyberattack, and CMS is working closely with states and encouraging Medicaid managed care plans to implement prospective payments to alleviate financial pressures. Importantly, Medicaid managed care plans do not require specific CMS authorization to issue these prospective payments, and are strongly encouraged to expedite this process to support their provider networks.
This announcement builds upon a prior statement from CMS indicating consideration of accelerated payments for Medicare Part A providers and advance payments for Part B practitioners and suppliers. These Medicare providers and suppliers are now able to submit requests for accelerated or advance payments directly to their respective Medicare Administrative Contractors (MACs) for individualized review and potential approval. This measure represents a significant step in providing financial relief through established health care programs.
CMS is committed to identifying further avenues of support for the provider and supplier community amidst this ongoing disruption. All affected providers and suppliers are advised to proactively contact health plans and other payers to explore available assistance options. CMS has also explicitly encouraged other payers, including Medicare Advantage (MA) organizations, to offer advance funding to providers impacted by the cyberattack. While the existing payment rules governing CMS payments to MA organizations and Part D sponsors remain unchanged, the agency is urging these organizations to consider the financial strain on their contracted providers and explore avenues for support within their existing program frameworks.
For detailed information on the Accelerated and Advance Payment Programs for Medicare Part A providers and Part B suppliers, please refer to the CMS Fact Sheet available at: https://www.cms.gov/newsroom/fact-sheets/change-healthcare/optum-payment-disruption-chopd-accelerated-payments-part-providers-and-advance.
Further details regarding the Biden-Harris Administration’s convening with the health care community concerning the Change Healthcare cyberattack can be found in the HHS readout: https://www.hhs.gov/about/news/2024/03/12/readout-biden-harris-administration-convening-health-care-community-concerning-cyberattack-change-healthcare.html.
