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More monetary relief is on the way for physicians and hospitals coping with last month's cyberattack on the nation's largest claims clearinghouse, according to a new initiative released by the Centers for Medicare and Medicaid Services (CMS).

Change Healthcare's electronic data interchange (EDI) clearinghouse has been offline since February 21 after hacker group AlphV/BlackCat infiltrated the system using ransomware. The disruption affected pharmacy operations and providers' ability to receive payer reimbursements, file electronic claims, and verify eligibility.

Within 2 weeks, federal authorities and Change's parent company, UnitedHealth Group (UHG), announced efforts to tide providers over until their computer systems are restored. CMS encouraged Medicare Advantage organizations, Part D sponsors, Medicaid, and CHIP managed care plans to funnel funds to providers more quickly by temporarily removing or relaxing prior authorization and timely filing requirements.

UHG launched a loan program administered through Optum Financial Services, offering short-term interest-free cash advances to providers whose payer payments are processed through Change's EDI. The loan amount, which must be repaid, is based on average prior claims volume and how much a provider's payment distributions have been affected.

Still, the financial lifelines fell short of industry expectations. The American Hospital Association and American Medical Association pleaded for a more robust government response, like the advance payments that kept physicians and hospitals afloat during the pandemic.

In a series of LinkedIn posts, a Pennsylvania primary care physician called Optum's loan offering "ludicrous." Christine Meyer, MD, said her practice's daily insurance reimbursements dropped from $70,000 to the lowest ever — just $1600. "My practice is losing $500,000 in charges each month, and we were offered a $4000 (per month) loan," she said.

On March 9, CMS released details of its plan to expedite payments to individual providers experiencing claims processing delays related to the cyberattack.

The Change Healthcare/Optum Payment Disruption program allows eligible Part A and Part B providers to request accelerated and advance payments in "amounts representative of up to 30 days of claims payments."

The CMS fact sheet said the expedited payment amount is calculated using the monthly average of total Medicare claims paid between August 1 and October 31. Repayment will begin immediately, with funds repaid in full over 90 days through "automatic recoupment from Medicare claims." On day 91, a demand letter will be issued for any remaining balance, and interest penalties will be applied after 30 days.

CMS notes that "no flexibilities regarding repayment timelines" will be given, and providers receiving periodic interim payments are ineligible. Providers should apply through their respective Medicare Administrative Contractor.

In a statement about the relief program, the agency said it recognizes that Medicaid providers have also been affected by the cyberattack and urged Medicaid managed care plans to consider making prospective payments to providers.

Meanwhile, UHG inches toward system restoration. Despite Bitcoin activity suggesting the healthcare behemoth may have paid hackers a multimillion-dollar ransom, UHG said in an update Friday that electronic payment functionality won't resume until March 15. Pharmacy operations, including e-prescribing and claims and payment transmissions, are operating normally, but medical claims filing will likely remain unavailable until the week of March 18.

Steph Weber is a Midwest-based freelance journalist specializing in healthcare and law.