The Centers for Medicare and Medicaid Services (CMS) will require health insurance companies to remove or relax requirements that often delay billing, such as requirements that doctors obtain prior authorization before providing certain care to patients. We plan to encourage them to do so. The agency is also encouraging private healthcare organizations to provide advance funding to organizations most affected by cyberattacks.
CMS also recognizes that “hospitals may face significant cash flow issues due to extraordinary circumstances impacting hospital operations,” and will reduce payments such as those made during the coronavirus pandemic. He said he would consider individual requests for expedited delivery. Senate Majority Leader Charles E. Schumer of New York requested such relief in a letter to federal officials on Friday.
The Feb. 21 hack of Change Healthcare, part of UnitedHealth Group, left tens of thousands of hospitals, doctors, and other health care providers unable to pay their medical bills. Industry and government officials said this was one of the most serious cyberattacks ever perpetrated against the U.S. health care system. Federal officials, including Health Secretary Xavier Becerra and Deputy Secretary Andrea Palm, held an emergency meeting with administration leaders and UnitedHealth on how to address the growing health care payment crisis, officials told The Washington Post. told.
Some hospitals and medical institutions are running out of cash after nearly two weeks of being cut off from filing medical claims and receiving payments from insurance companies. Some patients have experienced delayed treatment and lost access to discount cards and patient assistance programs through Change Healthcare's electronic clearinghouse, health care providers and industry officials said.
CMS directed health care providers to contact Medicare administrative contractors to enroll in a new electronic clearinghouse to process claims and directed contractors to expedite onboarding and claims processes. The department announced on Tuesday.
It was not immediately clear whether the measures announced by federal officials Tuesday would be sufficient to address concerns raised by health care providers across the country. UnitedHealth is offering short-term loans through its Optum medical services division to provide emergency funding to affected organizations, but doctors say the provision is inadequate.
This cyberattack has hit the healthcare industry hard, and officials say it highlights the growing digital risks facing healthcare systems. “This incident is a reminder of the interconnectedness of the nation's healthcare ecosystem and the urgency of strengthening cybersecurity resiliency,” HHS said in a statement.
Hackers stole data about patients, encrypted company files, and demanded money to unlock them. Change Healthcare then shut down much of its network in an attempt to recover. UnitedHealth declined to comment on reports that ransomware group ALPHV received a $22 million payout. “We remain focused on the investigation,” the company said in a statement Monday.
Change Healthcare processes 15 billion medical claims annually, far more than any other company, and is a critical pipeline between healthcare providers and insurance companies. Insurance companies review claims, pay for services, and determine the cost of a patient's treatment.
This is a developing story and will be updated.
