The federal government is urging UnitedHealth Group and other insurers to address cash flow issues among providers facing an absence of timely payments following the cyberattack on Change Healthcare in February.
The attack has significantly complicated operations for hospitals, insurers, physician practices and pharmacies nationwide, with the American Hospital Association calling it the "most significant cyberattack" on healthcare in American history.
CMS said March 9 it has made advance payments available to Medicare Part A providers and Part B suppliers that are experiencing financial challenges. On March 1, Change set up funding assistance for providers facing cash flow issues after losing access to its payer systems, which provider groups like the AHA have called insufficient.
In its March 10 letter, HHS called on UnitedHealth to "take responsibility to ensure no provider is compromised by their cash flow challenges" and to expedite the delivery of payments. The government is also urging the company to communicate about recovery efforts more frequently and with more transparency to both the healthcare system and state Medicaid agencies.
For all payers, HHS is asking that interim payments be made to affected providers and that prior authorization and other utilization management requirements be put on hold temporarily. The agency is also asking payers to simplify electronic data interchange requirements and accept paper claims.
"Larger payers in particular have the balance sheet stability to advance payments," HHS wrote. "Payers have the opportunity to stop-gap the cash flow concerns by stepping in with bridge payments."
"Just like the impacted providers, these payers are not responsible for the cyberattack; however, as hospitals and doctors have not wavered from their responsibility to care for their patients despite significant hardship, all payers must too honor their responsibility to support hospitals, physicians and patients for care delivered without delay," AHA President and CEO Rick Pollack said in a March 10 news release shared with Becker's.
CMS previously encouraged Medicare Advantage organizations and Part D sponsors to remove or relax prior authorizations, asked MA plans to extend advanced funding to affected providers, advised providers to request new electronic data interchanges from their Medicare Administrative Contractors for claims processing, and notified those contractors to accept paper claims.
Until March 31, UnitedHealth has suspended MA and D-SNP prior authorizations for outpatient services, except for durable medical equipment, cosmetic procedures and Part B step therapies. Utilization review for MA inpatient admissions and drug formulary exception review processes for Part D pharmacy benefits have also been temporarily suspended. Other large payers have not relaxed prior authorization requirements.
As of March 7, Change Healthcare's pharmacy electronic prescribing is fully functional for claim submission and payment transmission. Change is expected to have its electronic payment platform available for connection on March 15. Its medical claims network and software is expected to start testing for reconnection on March 18, with the company working throughout that week to restore service.
"We are committed to providing relief for people affected by this malicious attack on the U.S. health system," UnitedHealth CEO Andrew Witty said March 7. "All of us at UnitedHealth Group feel a deep sense of responsibility for recovery and are working tirelessly to ensure that providers can care for their patients and run their practices, and that patients can get their medications. We're determined to make this right as fast as possible."