Latest on Change Healthcare hack: Part B providers not offered advanced payments, must seek alternative recourse

by: Roy Edroso Mar 11, 2024

Fallout from the Change Healthcare hack continues.

The attack on the UnitedHealthcare payments company discovered on Feb. 21 necessitated a shutdown of numerous systems, leading to failures in electronic prescription processing, provider payments and clearinghouse claims processing (PBN 3/11/24).

In recent days UHC and payers that work with Change Healthcare, including HHS and CMS, have announced workarounds for affected health care workers; UHC said on March 7 that it had fixed the prescription issue, and that it would have all payment and claims processing back online between March 15 and March 18.

For Medicare, CMS announced on March 9 that it had created a “Change Healthcare/Optum Payment Disruption (CHOPD)” program for parties claiming “cash flow problems from the unusual circumstances impacting facilities’ operations.” CMS offers “accelerated payments to Part A providers and advance payments to Part B suppliers experiencing claims disruptions as a result of the Incident,” which have to be paid back after 90 days, sending these claimaints to their Medicare administrative contractors (MAC) for details.

The program conspicuously leaves out Part B providers, who had been advised in a March 5 HHS statement to approach their MACs for assistance. Instructions at the various MAC websites for Part B providers vary slightly. Novitas, for example, has a template for submission of CHOPD claims for Part A providers and Part B suppliers (see resources, below), which those entities are advised to complete and send to AAP@novitas-solutions.com. Part B providers are advised to use the MAC’s “Novitasphere” instead of their usual clearinghouse if that is unavailable, or use one of a number of alternatives including pre-approved third party billers or paper claims.

Noridian has detailed directions for “four alternative options for submitting claims” for providers stuck because of hack-related clearinghouse issues.

This is a developing story. Further updates to follow.

Resources

UnitedHealthcare, “UnitedHealth Group Update on Change Healthcare Cyberattack,” March 7: www.unitedhealthgroup.com/newsroom/2024/2024-03-07-uhg-update-change-healthcare-cyberattack.html

CMS, “Change Healthcare/Optum Payment Disruption (CHOPD) Accelerated Payments to Part A Providers and Advance Payments to Part B Suppliers,” March 9: www.cms.gov/newsroom/fact-sheets/change-healthcare/optum-payment-disruption-chopd-accelerated-payments-part-providers-and-advance

HHS, “HHS Statement Regarding the Cyberattack on Change Healthcare,” March 5: www.hhs.gov/about/news/2024/03/05/hhs-statement-regarding-the-cyberattack-on-change-healthcare.html

Novitas, “Request for Change Healthcare/Optum Payment Disruption Accelerated and Advance Payment,” March 9: www.novitas-solutions.com/webcenter/portal/MedicareJH/pagebyid?contentId=00288383

Novitas, “Claim submission options for impacted providers of the Change Healthcare cybersecurity incident,” March 8: www.novitas-solutions.com/webcenter/portal/MedicareJH/pagebyid?contentId=00288181

Nordian, “Change Healthcare Security Incident,” March 10: https://med.noridianmedicare.com/web/jeb/article-detail/-/view/10525/change-healthcare-security-incident

Blog Tags: claims processing, CMS, HHS, MACs, private payers

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