WASHINGTON, D.C. – CMS announced that, in addition to considering applications for accelerated payments for Medicare Part A providers, the Agency will also consider applications for advance payments for Part B suppliers impacted by the Change Healthcare/Optum Payment Disruption (CHOPD).
A related Fact Sheet issued on Saturday summarizes the scope of the relief and repayment guidelines:
- The CHOPD accelerated and advance payments may be granted in amounts representative of up to thirty days (30) of claims payments to eligible providers and suppliers. The average 30-day payment is based on the total claims paid to the provider/supplier between August 1, 2023 and October 31, 2023, divided by three. These payments will be repaid through automatic recoupment from Medicare claims for a period of 90 days. A demand will be issued for any remaining balance on day 91 following the issuance of the accelerated or advance payment.
Eligibility requirements and required certifications from the Fact Sheet include:
- CHOPD accelerated and advance payments must be requested for individual providers/suppliers – i.e. unique National Provider Identifier (NPI) and Medicare ID (PTAN) combinations.
- The provider/supplier has experienced a disruption in claims payment or submission due to a business relationship the provider/supplier, or the provider’s/supplier’s third-party payers, has with Change Healthcare or another entity that uses Change Healthcare or requires the provider/supplier to use Change Healthcare.
- The provider/supplier has been unable to obtain sufficient funding from other available sources to cover the disruption in claims payment, processing, or submission attributable to the Incident.
CMS’ release also notes that DME MACs will provide public information on how to submit a request for a Medicare accelerated or advance payment on their websites soon. As of this morning (3/11/24) Jurisdiction A and Jurisdiction D have updated their Change Healthcare Security Incident pages to include a link to the request template document. Check the related Jurisdiction B and Jurisdiction C pages for additional updates.
AAHomecare will share additional information from CMS and the MACs as it becomes available and continue to update our online resources related to the disruption.
- Collected announcements, resources and guidance from AAHomecare
- CMS Statement on Continued Action to Respond to the Cyberattack on Change Healthcare– Mar. 9, 2024
- Fact Sheet: Change Healthcare/Optum Payment Disruption (CHOPD) Accelerated Payments to Part A Providers and Advance Payments to Part B Suppliers