CMS: Emergency funding available to health care providers disrupted by cyberattack

The federal government will offer emergency funding to health-care providers and other professionals who are suffering financially in wake of the cyberattack on the nation’s largest processor of medical claims. The Centers for Medicare & Medicaid Services announced on Saturday that it will make available Change Healthcare/Optum Payment Disruption (CHOPD) accelerated payments to Part A providers and advance payments to Part B suppliers experiencing claims disruptions.

“CMS recognizes that providers and suppliers may face significant cash-flow problems from the unusual circumstances impacting facilities’ operations, preventing facilities from submitting claims and receiving Medicare claims payments when using the Change Healthcare platform,” the agency said in a statement. ”CMS has heard these concerns and is taking direct action to support the important needs of the health-care sector.”

The agency emphasized that the accelerated and advance payments are not loans and cannot be forgiven; indebtedness cannot be reduced; repayment timelines are not flexible; and standard recoupment procedures will be used to recover these amounts.

The CHOPD accelerated and advance payments may be granted in amounts representative of up to 30 days of claims payments to eligible providers and suppliers. The average 30-day payment is based on the total claims paid to the provider/supplier between August 1, 2023 and October 31, 2023, divided by three. These payments will be repaid through automatic recoupment from Medicare claims for a period of 90 days.

Providers and legislators welcomed the announcement. Senate Majority Leader Chuck Schumer, D-N.Y., along with Reps. Ami Bera, D-Calif., and Larry Bucshon, R-Ind., who are physicians, had pressed federal health officials to make more aid available to doctor groups. “The opening up of Medicare Part B will directly help our doctors on the front lines of this crisis who for weeks have been seeing unpaid bills pile up, threatening their ability to stay open and continue providing care to patients,” Schumer said in a statement.

CEO Farzad Mostashari of Aledade, the nation’s largest network of independent physician practices, previously had warned as many as one-fourth of practices were in financial distress. Although he told the Washington Post that the advanced payments will significantly help his members, there likely are more hard times ahead.

“Just having the system initially restored doesn’t mean that claims are going to be flowing or that payments are going to be flowing, potentially for weeks,” he said. “I worry a little bit that people are going to look at that announcement and say, ‘Oh, on March 18, money will be in my bank account.’ That is not the case.”

Related: CMS offers financial relief to providers affected by Change Healthcare outage

Meanwhile, CMS pledged to seek additional ways to help the industry recover. “CMS continues to monitor the Incident and its level of disruption,” it said. “Providers and suppliers should continue to work with all their payers for the latest updates on how to receive timely payments and any additional short-term funding programs offered through other payers. “