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    CMS Announces Flexibilities in Response to Change Healthcare Cyberattack

    Shahid Zaman, Director, Hospital Payment Policy
    For Media Inquiries

    On March 5, the Department of Health and Human Services (HHS) announced steps that the Centers for Medicare & Medicaid Services (CMS) is taking in response to the Change Healthcare cyberattack. Change Healthcare, a unit of United HealthGroup, announced Feb. 21 that it had been subject to a cyberattack, resulting in major disruptions across the health care sector to claims submission, pharmacy operations, payment processing, and insurance eligibility verifications.  

    In recognition of provider cash-flow challenges, the CMS stated that facilities may submit requests for Medicare accelerated payments to their Medicare administrative contractors (MACs). MACs will be providing additional information to providers about submitting these requests. Additionally, the CMS announced these flexibilities: 

    • MACs will expedite provider requests to change the clearinghouse they use for Medicare claims processing. The CMS also encourages Medicaid and Children’s Health Insurance Program (CHIP) agencies and Medicaid and CHIP managed care plans to expedite clearinghouse change requests.   

    • The CMS has encouraged Medicare Advantage and Part D sponsors, as well as Medicaid and CHIP managed care plans, to remove or relax prior authorization, utilization management, and timely filing requirements. The agency is also encouraging MA plans to provide up-front payments to affected providers.  

    • Providers should contact their MACs for exceptions, waivers, or extensions related to claims filing and contact the CMS related to quality reporting program flexibilities. 

    • Providers can submit paper claims to MACs if they are unable to submit electronically.  

    The CMS directs providers to the health care and public health sector Cyber Performance Goals website for more details on steps to stay protected.