March 11, 2024
Area(s) of Interest:
Cyber Security
Noridian Now Accepting Advance Payment Requests for Practices Affected by Cyberattack
After intense advocacy from the California Medical Association (CMA), American Medical Association (AMA) and other health care groups, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) announced on Saturday they would be offering advance payments for physicians and health care providers experiencing claims disruptions due to the cyberattack that caused a devastating nationwide outage that has left providers without revenue or the ability to submit claims for more than two weeks.
Noridian, California’s Medicare carrier, has now posted the form practices can fill out to request a Change Healthcare/Optum payment disruption Accelerated Payment [docx]. The form must be initialed for certification of facts and signed by the practice’s authorized official that is legally able to make financial commitments and assume financial obligations on behalf of the practice. The completed form should be sent to Noridian at PartBadvancepayments@noridian.com or via fax to (701) 277-7865. Noridian has advised CMA that it expects requests to be processed and money to be deposited within 7 business days of receipt of a request.
For additional information such as eligibility requirements, required acknowledgement of terms, and payment amount, please refer to the CMS Fact Sheet.
Noridian Accepting Paper Claims
Noridian is prepared to accept paper claims for providers that are still unable to submit electronic claims. However, please be aware that paper claims take a minimum of 29 days for payment.
The waiver request process is simple and Noridian has indicated it will process requests in two business days. Waiver requests should be submitted on practice letterhead and include your billing PTAN and indicate that you are requesting a waiver related to the Change Healthcare security incident. These requests can be faxed to (701) 277-7850.
DMHC Issues Guidance for California Health Plans
As a direct result of CMA advocacy, the California Department of Managed HealthCare (DMHC) is also strongly encouraging health plans to accept paper claims. In All Plan Letter 24-005, issued today, DMHC told plans in order to prevent further payment delays they should waive any requirements to submit claims electronically, and should automatically accept paper claims from providers, until Change Healthcare resumes operations or suitable electronic workarounds have been established.
The guidance also encourages plans to remove or relax timely claim filing requirements, given the difficulty – or in some cases, impossibility – of submitting claims at this time. DMHC said, however, that this does not relieve plans of their timely payment responsibilities, and advised that plans should establish workarounds to ensure claims are paid within the statutory timeframes.
At CMA’s urging, DMHC is also encouraging plans to remove or relax prior authorization and other utilization management requirements, to ensure that patient care is not delayed as the cyberattack and resulting outages continues to impact the ability of some providers to submit prior authorization requests.
Practices Encouraged to Check Liability Coverage
Physicians may carry business insurance policies that cover losses due to cyber events. Each policy will be different. Practices are encouraged to contact their liability insurers to find if their policy has cyber event coverage and if so, whether the particular loss falls within the policy’s coverage terms.
CMA continues to closely monitor this situation and will provide updates as they become available.
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