Updated March 15, 2024: CMS has updated the FAQs regarding “Change Healthcare/Optum Payment Disruption” (“CHOPD”) – Found Here
On February 21st, 2024, there was a ransomware cyber-attack identified impacting Change Healthcare (a clearinghouse division of UnitedHealth Group). Quoting a Reuters article which ran March 7th, “United’s Change Healthcare Unit is a vital lynchpin in the complex U.S. system for making and clearing insurance claims and electronic pharmacy refills… United Health Group (UHG) said it’s payment platform will be operational on March 15th, and its medical claims network will be restored on March 18th.”
CMS, HHS, AHCA, ADVION and Matrix have been sharing resources and options available to providers for optional solutions. Links to the latest CMS updates and payment disruption relief options:
Who is Impacted:
- Providers utilizing software vendors (Ex: Matrix) integrated with Change Healthcare clearinghouse services for claim processing and payment
- Many Payers including Medicare Advantage plans, some state Medicaid systems, and commercial payer claims processing and payment systems
Potential Fallout:
- Workaround needed for claims submission while Claims Management is down
- Change in process for rebilling a claim
- Delays resulting in untimely filing
- Inability to get remit information to post cash
- Potential need for submission of paper claims (CMS has contacted all Medicare Administrative Contractors, “MAC’s,” to ensure they are prepared to accept paper claims from providers)
Action Recommendations Provided for Provider-Specific Guidance:
- Contact software vendors
- Contact MAC
Provider Relief Options:
- All MACs will provide public information on how to submit a request for a Medicare accelerated or advance payment on their websites as early as Saturday, March 9th.
- Matrix has shifted to Inovalon as an alternative claims solution with the ability to create an 837 file out of Matrix. MatrixCare is hosting webinars this week for providers.
The Point Is: This cyber-attack has impacted the majority of our industry’s providers and suppliers. CMS has acknowledged the potential hardship and disruption pledging to work diligently for relief. Sincerely hoping this resolves quickly for all with the least amount of disturbance to providers and the patients we serve.
