Medicare Sets Up Accelerated Payment Program

CMS offers accelerated payments to providers affected by the Change Healthcare ransomware attack.

Many of our clients have experienced cash flow disruptions due to the ransomware attack on Change Healthcare, a subsidiary of UnitedHealth Group. Change Healthcare is the largest health care billing clearinghouse in the country, processing 14 billion transactions annually. The system suffered a cyberattack on February 21, 2024, and has still not recovered operations.

Because of the significant financial losses being experienced by health care providers, the Centers for Medicare and Medicaid Services (CMS) has set up an accelerated payment program for Part A and Part B providers and suppliers, called the Change Healthcare/Optum Payment Disruption (CHOPD) program. Advance payments may be up to thirty days of claims payments to eligible hospitals, physicians and other providers and suppliers. (Providers that receive Periodic Interim Payments [PIP] are not eligible.) The program will be administered by the Medicare Administrative Contractors (MACs). To be eligible for CHOPD payments, the provider/supplier must submit a certification to the MAC stating, among other things, that:

• The provider/supplier is not able to submit claims to receive Medicare payments due to a business relationship involving Change Healthcare
• The provider/supplier has been unable to obtain sufficient funding from other sources to cover the disruption in claims processing
• The provider/supplier is not insolvent and does not intend to cease operations.

The maximum allowable amount will be 30 days of Medicare claims payments based on total claims paid to the provider/supplier between August 1, 2023, and October 31, 2023, divided by three. Payments under the CHOPD program are not loans but rather advances of Medicare payments. They will be recovered through recoupment as claims are processed and if any balance remains unpaid after 90 days, interest will accrue.

Health care providers experiencing disruption in claims submission should submit the form required by the MAC covering their area. A list of MACS is available at https://www.cms.gov/mac-info.

For further information, contact us.