HHS responds to physician concerns raised after Change Healthcare cyberattack

Health and Human Services on Tuesday responded to physician concerns raised after the Change Healthcare cyberattack, noting that it plans to grant flexibilities for those grappling with cash flow concerns.

The department said it is in regular contact with Change parent company UnitedHealth Group, along with other state partners and stakeholders. Through such conversations, HHS hopes to “better understand the nature of the impacts and to ensure the effectiveness of UHG’s response.”

Hackers first hit the vendor on Feb. 21, hampering radiologists’ ability to process payments and check insurance eligibility. The attack is costing providers $100 million each day, according to one estimate, with reports claiming UnitedHealth paid a $22 million ransom to try and end the attack.

“Numerous hospitals, doctors, pharmacies and other stakeholders have highlighted potential cash flow concerns to HHS stemming from an inability to submit claims and receive payments,” the department said in a March 5 statement. “HHS has heard these concerns and is taking direct action and working to support the important needs of the healthcare community.”

Both the Medical Group Management Association and American Medical Association recently wrote to HHS Secretary Xavier Becerra, detailing the enormous impact the attack is having on physicians. In response, the feds are taking the following actions:

  • Radiologists needing to change clearinghouses used for claims-processing during the outage should contact their Medicare Administrative Contractor to request a new electronic data interchange enrollment for the switch.
  • The Centers for Medicare & Medicaid Services will issue guidance to Medicare Advantage organizations and Part B sponsors, urging them to remove or relax prior authorization and other utilization management requirements during the outage.
  • CMS also is “strongly” encouraging Medicaid and CHIP managed care plans to do the same, along with considering offering advanced funding to radiologists and other physicians.
  • Medicare providers having trouble filing claims or other necessary notices should contact their MAC for details on exceptions, waivers or extensions.
  • The agency also has contacted MACs to make sure they’re prepared to accept paper claims from physicians who need to file them.

CMS will continue communicating with the provider community about this issue, “as appropriate.” The agency has received requests from providers about the possibility of accelerated payments during the interruption, similar to what CMS offered during the pandemic. Hospitals may submit such requests to their MACs for individual consideration, officials noted. However, the announcement did not instruct physicians to do the same.  

“HHS also takes this opportunity to encourage all providers, technology vendors, and members of the healthcare ecosystem to double down on cybersecurity, with urgency,” the statement closed. “The system and the American people can ill afford further disruptions in care.”

MGMA—which represents more than 15,000 medical group practices across radiology at other specialties—issued its own response the HHS news on Tuesday.

“Physician practices are in no way immune to the significant cash flow problems resulting from this incident and are often far more vulnerable than hospitals able to carry larger financial reserves,” Anders Gilberg, senior VP of government affairs for the association, said March 5. “CMS must require its contractors to extend the availability of accelerated payments to physician practices in a similar manner to which they are being offered to hospitals.”

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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