Biden Administration announces advanced payments for physicians affected by cyberattack

March 09, 2024
Area(s) of Interest: Cyber Security 

NOTE: Noridian, California’s Medicare carrier, has now posted the form practices can fill out to request a Change Healthcare/Optum payment disruption Accelerated Payment [DOCX].

After intense advocacy from the California Medical Association (CMA), American Medical Association (AMA) and other health care groups, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) announced today it will institute Change Healthcare/Optum Payment Disruption advance payments for physicians and health care providers experiencing claims disruptions due to the cyber-attack that caused a devastating nationwide outage that has left providers without revenue or the ability to submit claims for more than two weeks.  

On Feb. 21, 2024, Change Healthcare, a subsidiary of the UnitedHealth Group Optum unit, experienced a cyber-attack that resulted in nationwide outages affecting payors, physician practices and other providers and pharmacies. The outage has caused interruption of numerous administrative and billing processes, including electronic claims submission, provider payments, pharmacies, prior authorizations, payor chart retrieval, etc. 

The advance payments announced today, equivalent to up to 30 days of claims payments, will be repaid through automatic recoupment from Medicare claims over a 90-day period, with any remaining balance due on day 91. Eligible providers and suppliers can request accelerated or advance payments for Medicare claims if they meet specific criteria, including not being able to submit claims for payment, experiencing a disruption in claims processing, and intending to continue operations. Advance payments will be repaid through automatic recoupment from Medicare claims over a 90-day period, with any remaining balance due on day 91. 

Physician practices will be able to apply for advance payments through California’s Medicare carrier, Noridian. While specific instructions are not yet available,  practices should check the Noridian website on Monday for the application portal. CMA will also post the information once it becomes available.  

The CMAAMA and other health care organizations have urged HHS Secretary Xavier Becerra to use all available authorities to ensure that physician practices can continue to function, and patients can continue to receive the care that they need. 

"Physician practices have been grappling with this unprecedented crisis, severely disrupting operations, impacting patient care and threatening the survival of practices" said CMA President Tanya W. Spirtos, M.D. "We appreciate the Biden administration for responding to the call from physicians and we urge continued action. It’s hard to overstate the hardships this cyberattack has caused as it has diverted precious resources and focus that should be spent on patient care.” 

CMS has directed its Medicare contractors to expedite actions needed for providers and suppliers to change their clearinghouses and to accept paper claims if necessary. 

CMA has also been working with the California Department of Managed Health Care (DMHC) to request flexibilities for physician practices when submitting claims, relaxation of prior authorization requirements and enforcement of health plans’ timely payment requirements. 

CMA has been advocating for these measures and will continue to work closely with CMS to ensure that physician practices receive the necessary support and assistance. CMA will provide further updates as the situation develops.  


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