Federal regulators are opening pathways to shore up nursing homes’ finances in the wake of a cyberattack that has impacted Medicare and Medicaid billing nationwide.
Specifically, the Centers for Medicare & Medicaid services will be considering applications for accelerated payments for Medicare Part A providers and advanced payments for Part B suppliers.
Medicaid providers also have been struggling with cash flow problems in the wake of the cyberattack on Change Healthcare, the nation’s largest healthcare billing clearinghouse — a fact that CMS acknowledged in a statement Saturday.
“CMS also recognizes that many Medicaid providers are deeply affected by the impact of the cyberattack,” the agency said. “We are continuing to work closely with States and are urging Medicaid managed care plans to make prospective payments to impacted providers, as well.”
Providers can request accelerated or advanced payments up to an amount equal to the monthly average payment they received between August and October of 2023, according to a CMS fact sheet.
The funds will be considered an advance, not a loan, and CMS is reserving the right to recoup payments and conduct audits as necessary in the future.
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Long-term care leaders have praised the relief actions as important steps to keeping the sector healthy in the wake of the cyberattack. But more steps should be taken to stave off short-term cash flow problems, according to Martin Allen, senior vice president of reimbursement policy at the American Health Care Association.
“We are pleased that CMS has recognized the significant impact this has had on providers and, as a result, has developed a streamlined accelerated payment process,” he said. “However, there is still work to be done to ensure that impacted providers receive payments in an efficient, timely manner.”
Specifically, AHCA requested Additional Documentation Request audit relief last week — something that CMS has not yet addressed, Allen said.
“We remain in communication with Federal entities to support the collaborative development of solutions,” he noted.
The nation’s top nonprofits-only nursing home association also has been active in advocating for its members. President and CEO Katie Smith-Sloan outlined her group’s concerns and suggestions in a Thursday letter to Xavier Becerra, secretary of the US Department of Health and Human Services.
For their part, federal regulators seem to be willing partners in helping address the billing emergency.
“The effects of this attack are far-reaching,” wrote Becerra and Julie Su, acting secretary of the US Department of Labor Sunday. “Change Healthcare, owned by UnitedHealth Group, processes 15 billion healthcare transactions annually and is involved in one in every three patient records…. In a situation such as this, the government and private sector must work together to help providers make payroll and deliver timely care to the American people.”
