On November 1, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee Schedule (MPFS) final rule for Calendar Year (CY) 2025 (CMS-1807-F). The rule updates payment policies and rates for Part B services furnished under the…
CMS to Provide Advanced Payments to Those Affected by the Change Healthcare Cyberattack
On Saturday, March 9, the Centers for Medicare & Medicaid Services (CMS) released a statement and a fact sheet regarding the cyber-attack on Change Healthcare. CMS announced that it will offer accelerated payments to Medicare Part A providers, and advance payments to Part B suppliers and providers who have experienced payment disruptions due to the cyberattack. It is important to note that the payments are not a loan and cannot be forgiven.
The payments are simply an advance to help providers and suppliers meet their obligations. The fact sheet outlines the entities eligible for the Change Healthcare/Optum Payment Disruption (CHOPD) program and outlines how the agency will determine the payment amount for providers and suppliers. The payment amount is selected by the provider/supplier and
comprised of two options:
- The maximum allowed amount is calculated by CMS and represents 30 days of Medicare claims. The average 30-day payment amount will be calculated as total claims paid for a three-month period (August 1, 2023 – October 31 of 2023), divided by three.
- Providers/suppliers may choose a specific amount that does not exceed the maximum allowable amount. Eligible providers/suppliers are those that have unique National Provider Identifiers (NPI) or have a Medicare ID combination, such as a Provider Transaction Access Number (PTAN). Additionally, CMS notes that the granting of accelerated or advance payments is not guaranteed, the length of the program is determined by the duration of the incident, and the
payment program can be terminated at any time. Providers and suppliers are urged to contact their Medicare Administrative Contractor (MAC) for help and information. The list of MACs can be found on here: MAC list.
On March 13, CMS published FAQs related to the Change Healthcare/Optum payment disruption accelerated and advance payments. These go into detail about what services qualify for accelerated and advance payments, application criteria, terms of repayment, financial concerns, and other topics.
As a reminder, the AMA has a website on the Change Healthcare cybersecurity issue that outlines the latest developments, information for physician practices, and related AMA advocacy.
