The U.S. Departments of Health and Human Services, Labor and the Treasury announced June 14 a 120-day exception period for providers impacted by the Change Healthcare cyberattack to initiate No Surprises Act payment disputes. The action is in response to providers and facilities unable to submit disputes because they did not receive necessary payment information or disclosures from health insurance plans due to disruptions in claims processing resulting from the cyberattack on Change Healthcare.
Providers and facilities whose ability to initiate open negotiation for services provided on or after Jan. 1, was impacted by the cyberattack now have until Oct. 12 to initiate the process regardless of when the payment or notice of denial of payment were transmitted. These providers will not need to request individual exceptions through the independent dispute resolution federal portal as previously requested by the departments. Instead, the government published an attestation that providers and facilities must furnish to plans or issuers along with the standard open negotiation initiation form.
In a separate announcement, the Centers for Medicare and Medicaid Services (CMS) announced payments under the Accelerated and Advance Payment Program for the Change Healthcare/Optum Payment Disruption will end July 12. CMS began the advanced payments to ease cash flow disruptions experienced by some Medicare providers and suppliers, such as hospitals, physicians and pharmacists, due to the unprecedented cyberattack that took Change Healthcare offline in February.
For more information or if you have questions, contact Katie Keysor, American College of Radiology® Senior Director of Economic Policy.
No Surprises Act Has Little Impact on In-Network Imaging Claims
GAO reports the No Surprises Act had minimal impact on radiology, with inânetwork claims steady at ~99% and slight declines in payment rates.
Read moreState Healthcare Bills to Watch
States advance bills on scope of practice, corporate medicine, prior authorization, and telehealth as February ends and March begins.
Read moreACR Provides Policy Guidance to HHS on Clinical AI
ACR recommended stronger AI oversight, more research funding, and sustainable Medicare payment to support safe clinical AI adoption.
Read more