June 21, 2024
Payers | Tea Leaves
  • The Centers for Medicare and Medicaid Services (CMS) announced the conclusion of its financial relief program for providers impacted by the Change Healthcare cyberattack. Starting July 12, CMS will no longer accept new applications for accelerated or advance payments, ending a program launched in March in response to the cyberattack on Change Healthcare, a UnitedHealth Group subsidiary. The attack caused extensive disruptions across health care organizations, affecting billing, payments, prior authorization, and insurance verification processes. CMS provided over $2.55 billion in accelerated payments to about 4,200 hospitals and Medicare Part A providers, while doctors, durable medical equipment suppliers, and other Part B suppliers received more than $717.18 million in advance payments to mitigate cash flow challenges caused by delays in claims submission and payments. (Articles here and here)
  • Lawmakers are aware of the pressing need to address Medicare’s financial stability but have yet to agree on a clear path forward. In a recent House Budget Committee hearing, members from both parties expressed concern over the program’s mounting financial challenges, exacerbated by an aging population and declining worker contributions. They discussed the potential for Medicare’s Hospital Insurance Trust Fund to run dry by 2036 if left unaddressed. Proposals to increase taxes or adjust benefits face significant political hurdles, particularly with senior voters. Despite bipartisan discussions and proposals, including a Republican plan for a premium support model, consensus on reforms remains elusive. Some lawmakers advocate for a bipartisan commission to explore viable solutions, emphasizing the need for collaborative efforts to ensure Medicare’s long-term stability. (Article here)