CMS publishes FAQ on CHOPD accelerated and advance payments

Wednesday, March 27, 2024

CMS recently published an FAQ on the Change Healthcare/Optum payment disruption (CHOPD) accelerated and advance payments being issued to Part A providers and Part B suppliers experiencing delays in claims payments due to the recent cyberattack on Change Healthcare. The FAQ provides clarity on application criteria, the repayment process, and further action from CMS.

CHOPD payment is intended to cover up to 30 days of Medicare claims, and providers and suppliers have 90 days for repayment. Although CMS doesn’t currently have a projected end date for this program, it expects these payments will no longer be available once the disruptions are resolved, according to the FAQ.

Medicare Administrative Contractors (MAC) are aiming to review requests and notify providers and suppliers of the outcome within five business days of receipt, says CMS.

CMS is requiring providers and suppliers to certify that they have obtained, or attempted to obtain, emergency financing from other sources, according to the FAQ. Although facilities are not required to submit proof of this in their application, they should maintain this supporting documentation in the event of post payment audits.

Repayment of CHOPD payment will occur in the same manner as traditional recoveries, according to the FAQ. Recoupment will begin the day after the payment is issued, and providers and suppliers have 90 days to repay the payment.

If a provider or supplier is unable to repay the full CHOPD accelerated or advance payment in 90 days, they will be issued a demand letter requiring immediate repayment of the remaining balance on the 91st day. Facilities can contact their MAC for more information on how to request an extended repayment schedule.

Providers and suppliers should expect to see the CHOPD accelerated or advance payment recoupment reflected on their remittance advice. The recoupment will appear as an adjustment in the provider-level balance section, and it will be coded to include “CHD.”

Revenue integrity professionals should review the FAQ to determine if they are eligible for CHOPD accelerated or advance payment and understand what the process entails. Contact your MAC for additional information.

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