AHCA/NCAL: Change Healthcare Update – CMS Posts Accelerated Payments FAQs

Clarifications Address Provider Eligibility Questions

The Centers for Medicare and Medicaid Services (CMS) yesterday posted a fact sheet with additional guidance for providers and Medicare Administrative Contractors impacted by the Change Healthcare security incident. The fact sheet specifically focuses on frequently asked questions about implementing the Change Healthcare/Optum Payment Disruption (CHOPD) Accelerated Payments program.

This information comes following AHCA/NCAL’s participation in a roundtable discussion earlier this week with the White House, the U.S. Department of Health and Human Services (HHS), the Department of Labor, and other health care community leaders to discuss ways to mitigate patient and provider harms caused by the cyberattack. Additionally, AHCA/NCAL submitted written questions and proposed solutions to HHS and CMS to help clarify the recently issued Accelerated Payment guidance.

In the CMS Fact Sheet, there are two Application Criteria FAQs that may be especially helpful for providers:

• Question 6: Clarifies that a skilled nursing facility receiving a Periodic Interim Payments (PIP) for bad debts but does not receive Medicare Part A PPS payments via PIPs is eligible to receive an Accelerated Payment if all other requirements are met.

• Question 10: Clarifies that a provider is eligible to receive an Accelerated Payment if they are experiencing a delay in claims submission and processing, which has resulted in a disruption of some Medicare claims payments related to this cyber incident. All other requirements must also be met. CMS does not require providers to quantify the level or percentage of impact to their Medicare claims.

AHCA/NCAL will continue to advocate on behalf of impacted members and provide updates. Please reach out to Grant Beebe or Dan Ciolek with any questions.

NYSHFA | NYSCAL CONTACTS:

Tarrah Quinlan, RN, BSN
Director of Education Program Development and Member Operations
518-462-4800 x20

Jackie Pappalardi, RN, BSN
Senior Director of Grant Management & Member Services
518-462-4800 x16