News Releases

Accelerated and Advance Payments Available to Hospitals and Providers in Aftermath of Cyberattack on Change Healthcare

The Centers for Medicare & Medicaid Services (CMS) recently made accelerated payments available to hospitals and providers and issued guidance to those affected by the February cyberattacks on Change Healthcare.

Referred to by the American Hospital Association (AHA) as the “most consequential cyberattack against the U.S. healthcare system in history,” this attack has made it more difficult for hospitals to provide patient care, submit insurance claims, fill prescriptions and receive payment for the essential healthcare services they provide.

Accelerated and Advance Payments (AAP)

In response to hospitals and providers facing financial challenges in the wake of the attack, CMS recently made Change Healthcare/Optum Payment Disruption (CHOPD) accelerated payments available to Part A providers and advance payments to Part B suppliers experiencing claims disruptions. These payments can be granted in amounts representative of up to 30 days of claims payments to eligible providers and suppliers and will be repaid through automatic recoupment from Medicare claims for a period of 90 days.

These CHOPD accelerated advanced payments are available for a limited time. Traditional AAPs are reviewed individually on a case-by-case basis. Learn more about CHOPD by visiting the CMS frequently asked questions page.

Change Healthcare and the Financial Impact of the Cyberattack

A subsidiary of UnitedHealth Group, Change Healthcare is responsible for more than 100 critical functions that keep the healthcare system operating, including the management of clinical criteria used to authorize a substantial portion of patient care and coverage, processing billions of claims, supporting clinical information exchange and processing drug prescriptions.

According to Change Healthcare, the company processes more than 14 million healthcare transactions per year and touches one in every three patient records.

Due to the extensive impact of the attack, significant portions of Change Healthcare’s functionality have been disrupted. This means billions of dollars have been unable to reach hospitals and providers, which consequently threatens the financial viability of hospitals, physicians and other providers. In some areas of the country, patients have experienced difficulties in obtaining prescriptions and have faced delays in scheduling care.

The level of fiscal impact on hospitals varies depending in part due to location, with rural hospitals facing stronger financial struggles. Change Healthcare’s downed systems are stifling providers’ ability to confirm health insurance for patients, process and receive payments and exchange clinical records. This loss of revenue may lead to hospitals being unable to pay staff and purchase necessary supplies.

A recent survey conducted by American Hospital Association indicated 94% of hospitals reported some financial impact stemming from the attack, with 82% of hospitals stating their cash flow was impacted. Approximately 1,000 hospitals were surveyed, and of those, nearly 60% reported an impact to revenue of $1 million or more per day.

AHA has requested Congress take additional actions to support providers and asked UnitedHealth Group and commercial payers to support patients and providers by waving prior authorization and timely filing requirements, as well as advancing payments.