The U.S. Department of Health and Human Services (HHS) issued a statement on what actions it is taking related to the February 21 cyberattack upon Change Healthcare and options for providers impacted by corresponding outages.

HHS said it has regular contact with UHG leadership on the matter and has stressed that UHG is expected to do, “everything in its power to ensure continuity of operations for all health care providers impacted.”

Cash Flow Issues. Much of the statement focuses on how providers should look to their payers to provide financial assistance while Change Healthcare remains out of service, noting “many payers are making funds available while billing systems are offline, and providers should take advantage of these opportunities.”  This statement gives the appearance that HHS would prefer not to be in the role of providing financial assistance for cash flow if it can avoid it.  In addition, while HHS notes the availability of accelerated payments, it seems to suggest that they may be limited to hospitals who are experiencing “significant cash flow problems from the unusual circumstances.”  However, there should be more clarity on this matter later this week when the Centers for Medicare and Medicaid Services (CMS) issues its guidance for the Medicare Administrative Contractors (MACs) regarding the specific information and items providers will need to submit with their accelerated payment requests.

CMS also outlined a series of other flexibilities it is putting in place to assist providers with the challenges resulting from the outage:

• Expedited EDI enrollment. Providers wishing to change clearinghouses are required to submit a request for a new electronic data interchange (EDI) enrollment and the MAC is to assist in expediting this process.
• MACs must be prepared to accept paper claims. For providers who are left no alternative but to submit paper claims, the MACs must be set up to accept them.
• Providers can seek waivers and exceptions from MACs.  Providers who are having difficulty submitting claims or meeting required timely filing notices or submissions can reach out to their MACs for information on available waivers, exceptions or extensions. Providers should reach out to CMS if needing similar assistance related to their Quality Reporting Program requirements, which often use claims data to calculate measures and penalize providers for incomplete data.
• Managed care plans encouraged to offer providers certain flexibilities. CMS will be issuing guidance to Medicare Advantage MA and Part D plans “encouraging” them to remove or relax prior authorization, other utilization management and timely filing requirements during these outages. Note that CMS is not requiring plans to waive these requirements.  So providers should check with their plan contacts to determine what if any flexibilities will be provided.  CMS is also strongly encouraging Medicaid and CHIP managed care plans to adopt similar flexibilities and offer interim, advance funding support to providers.

LeadingAge will share the additional CMS/HHS guidance as it becomes available but in the interim, providers should reach out to the managed care plans they work with to see if they are offering advance funding to assist with cash flow or waiving certain prior authorization or timely filing requirements due to the cyberattack.