Biden Gives Billing Arbitration Grace Period to Providers

In the aftermath of the Change cyberattack, some providers are struggling to begin the process.

Months after the ransomware attack that halted operations for a substantial number of providers across the country, some are having issues beginning the independent dispute resolution process for out of network claims.

To help providers, the Biden administration—under the No Surprises Act—is giving them until October 12 to start the negotiation process for services provided this year. This timeframe could be extended, if needed, according to a CMS notice.

In addition to preventing them from providing services, the effects of the ransomware attack have delayed providers accessing the information needed to proceed with the billing process. Such information includes date of plan payment and coverage denials.

In March, UnitedHealth Group, Change Healthcare’s parent company, advanced over $2 billion to help providers whose revenue cycle operations were disrupted due to the attack. UnitedHealth also suspended prior authorizations for select outpatient services and utilization reviews of inpatient admissions for Medicare Advantage plans.

West Virgina-based Davis Health System was affected by the Change Healthcare attack, which negatively impacted their ability to provide care to its patient population.

“Without being able to get prior authorization and insurance verification, many patients do not want to take the risk of having their insurance not cover the procedure,” Catherine “Mindy” Chua, the system’s CMO previously told HealthLeaders.

The financial impact on the system was also significant. Unable to receive payments from insurers affected its amount of cash on hand. Claims had to be processed manually and revenue cycle staff had to hand-key claims since they were unable to use the system’s EHR.