May 15, 2025
Area(s) of Interest:
Cyber Security
What You Need to Know: More than a year after the Change Healthcare cyberattack, physician practices are still facing timely filing denials and financial fallout. Despite state guidance calling for flexibility, some health plans continue to deny claims, and practices are urged to contact CMA for support.
More than a year after the massive cyberattack on Change Healthcare, a subsidiary UnitedHealth Group’s Optum unit, many physician practices are still grappling with the fallout. Though UnitedHealth Group reported that claims began flowing again in late March 2024, serious disruptions persisted into late 2024, putting significant financial strain on some physician practices.
The major challenge continues to be timely filing denials by health plans, which is threatening the financial viability of some practices. Several practices who utilized Optum as their revenue cycle management (RCM) vendor were especially impacted, reporting that Optum RCM was unable to submit claims until October 2024, which led to large volumes of timely filing denials. While Optum provided temporary loans to help bridge the revenue gap during the outage, some practices are struggling to repay those loans without having received the revenue those claims should have generated.
The California Medical Association (CMA) worked with the California Department of Managed Health Care (DMHC) to ensure physician practices would still be able to be paid for services, even if claims didn’t meet the timely filing requirements under law or contract. As a result, DMHC issued All Plan Letter 24-005, laying out flexibilities it expected plans to offer to ensure delivery system stability following the cyberattack, one of which was a removal or relaxation of timely filing limits. The DMHC guidance also advised that plans should not require providers to appeal under the “good cause” exception under law, as doing so would further delay claims processing and reimbursement to practices.
Despite this guidance from DMHC, CMA and the American Medical Association are both receiving reports of practices impacted by the cyberattack receiving timely filing denials.
If your practice has been affected, CMA is committed to supporting practices.
Practices still experiencing timely filing denials or struggling to repay temporary loans due to unpaid claims from the cyberattack are encouraged to contact CMA’s Center for Economic Services at (800) 786-4262 or economicservices@cmadocs.org.