CMS Announces End of Cyber ​​Attack Relief Program

The Centers for Medicare & Medicaid Services (CMS) announced the conclusion of a program that provided billions in Medicare advance payments to people affected by the Change Healthcare/UnitedHealth Group cyberattack last winter. The Accelerated Early Payment Program, which began in early March to help hospitals and practices facing significant reimbursement delays, will stop accepting applications after July 12, 2024.

CMS reported that the program advanced more than $2.55 billion in Medicare payments to more than 4,200 Part A providers, including hospitals, and more than $717.18 million in payments to Part A providers. Part B such as physicians, non-physician practitioners, and suppliers of durable medical equipment.

According to CMS, the Medicare billing system is now functioning properly and 96% of first payments have been recovered. Advances were to represent ≤ 30 days of typical claims payments over a 3-month period in 2023, with full repayment expected within 90 days through “automatic Medicare claims recovery” – no extensions allowed.

The agency took a victory lap regarding its response. “In the face of one of the most widespread cyberattacks on the U.S. healthcare industry, CMS quickly took action to allow providers and suppliers access to the funds they needed to continue providing life-saving patient care,” said CMS Administrator Chiquita Brooks-LaSure. A declaration. “Our efforts have helped minimize the disruptive consequences of this incident, and we will remain vigilant to be prepared for future events.”

Ongoing Concerns of Health Care Organizations

Ben Teicher, a spokesman for the American Hospital Association, said Medscape Medical News that the organization hopes CMS will be responsive if there is more need for action after the advance payment program expires. The organization represents approximately 5,000 hospitals, health care systems and other providers.

“Our members report that the aftereffects of this event will likely be felt for the rest of the year,” he said. According to Teicher, hospitals remain concerned about their ability to process claims and denial appeals, the security of reconnecting to cyber services, and access to information needed to bill patients and reconcile payments.

Additionally, hospitals are concerned about “financial support to mitigate the considerable costs caused by the cyberattack,” he said.

Charlene MacDonald, executive vice president of public affairs at the Federation of American Hospitals, which represents more than 1,000 for-profit hospitals, sent a statement to Medscape Medical News That said, some providers “are still feeling the effects of denials of care and delays caused by insurer inaction.”

“We appreciate that the administration has acted within its authority to support providers during this unprecedented crisis and mitigate these devastating impacts, particularly because a large majority of managed care companies have failed to take responsibility,” she said. “Now is the time to focus on holding accountable plans that use tactics to delay and deny necessary care to patients.”

Impact and response to cyberattacks

The ransom-based cyberattack on Change Healthcare/UnitedHealth Group targeted an electronic data clearinghouse processing payer reimbursement systems, disrupting hospital and physician office cash flow, and impacting patient access to prescriptions and to vital therapies.

Change Healthcare – part of UnitedHealth Group’s Optum subsidiary – processes half of all medical claims, according to a Justice Department lawsuit. The American Hospital Association described the cyberattack as “the largest and most consequential incident of its kind” in U.S. history.

In late March, UnitedHealth Group said almost all medical and pharmacy claims were being processed properly, while an assistant secretary at the U.S. Department of Health and Human Services told clinicians that authorities were focusing on the last group of clinicians facing cash flow problems.

Still, a senior CMS advisor told providers at the time that “we’ve heard from many providers over the last few weeks who are really struggling to make ends meet right now or who are worried that they won’t be able to.” pay their salaries. the coming weeks.”

Randy Dotinga is a freelance health and medical journalist and board member of the Association of Health Care Journalists.