CMS Introduces CHOPD Accelerated Payments to Mitigate Change Healthcare Cyber Attack Impact
In response to the cyberattack on UnitedHealth Group’s subsidiary Change Healthcare/Optum in late February, the U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) are taking swift action to address the disruption caused to health care operations nationwide.
CMS, in close coordination with UnitedHealth Group and Change/Optum, is actively engaging with the health care sector to ensure timely communication and provide viable options for interim payments to affected providers and suppliers. Recognizing the significant cash flow challenges faced by facilities operating on the Change Healthcare platform, CMS announced the availability of Change Healthcare/Optum Payment Disruption (CHOPD) accelerated payments to Part A providers and advance payments to Part B suppliers.
Key Points:
Support for Providers and Suppliers:
- CMS is offering accelerated payments to Part A providers and advance payments to Part B suppliers experiencing claims disruptions due to the cyberattack on Change Healthcare/Optum.
- Eligible providers and suppliers may receive payments representing up to 30 days of claims payments, calculated based on the average 30-day payment between August 1, 2023, and October 31, 2023.
Repayment and Terms:
- The CHOPD accelerated and advance payments will be repaid through automatic recoupment from Medicare claims over a 90-day period.
- A demand for any remaining balance will be issued on day 91 following the payment issuance.
- Providers and suppliers must meet specific eligibility criteria, including experiencing disruption in claims payment or submission related to the cyberattack.
- Certifications and acknowledgments are required, ensuring the funds are used for operations, and providers are not under investigation or facing financial hardships.
Acknowledgment of Terms:
- Providers and suppliers must acknowledge that the funds are not a loan, cannot be forgiven, and repayment will follow standard recoupment procedures.
- Interest will accrue 30 days after a demand is issued.
Post Payment Audits and Program Length:
- CMS retains the right to conduct post-payment audits related to accelerated or advance payments issued under the program.
- The program’s length is contingent on the duration of the cyberattack incident, and CMS may terminate it at any time.
Provider Flexibility:
- Providers facing financial hardship may request an Extended Repayment Schedule after a demand is issued.
This initiative aims to provide immediate financial relief to health care providers and suppliers affected by the Change Healthcare/Optum cyberattack, ensuring the continuity of essential health care services. CMS encourages impacted entities to work closely with payers for updates and explore additional short-term funding programs.
As the situation unfolds, CMS remains vigilant, actively monitoring the incident’s impact on health care operations and standing ready to adapt its response accordingly. The CHOPD accelerated payments program reflects a collaborative effort to mitigate the challenges posed by the cyberattack and uphold the stability of the health care sector.
Reference
CMS
