More lawmakers are calling on the Health and Human Services Department to intensify its efforts to help providers weather the effects of the ongoing Change Healthcare outage.
A bipartisan group of 96 House members wrote HHS Secretary Xavier Becerra Tuesday asking the department to offer swifter aid to providers and to ramp up the pressure on UnitedHealth Group, which operates Change Healthcare within its Optum subsidiary, to do more. Becerra also faced questions about the situation at two House committee hearings Wednesday.
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"We request that HHS use its existing authorities to ensure that money that should be flowing for services rendered under traditional Medicare and Medicare Advantage, and under Medicaid, continues to do so," lawmakers led by Reps.Mariannette Miller-Meeks (R-Iowa) and Robin Kelly (D-Ill.) wrote in the letter to Becerra. Rep. Brett Guthrie (R-Ky.), who chairs the health subcommittee of the Energy and Commerce Committee, is among the signatories.
The letter urges HHS to relax repayment terms associated with advanced payments the Centers of Medicare and Medicaid Services is offering providers under Medicare, Medicaid and the Children's Health Insurance Program.
“If the department needs flexibilities granted in law, please let us know so we can work together to ensure patient access and care are not negatively impacted,” the House members wrote. The American Medical Association, which has criticized HHS' and UnitedHealth Group's response to the outage, distributed the lawmakers' letter to the media.
"Members of Congress have heard from constituents and agree with the AMA that more must be done to respond to the cyberattack," AMA President Dr. Jesse Ehrenfeld said in a statement Wednesday.
Although Congress has not directly ventured into the Change Healthcare cyberattack that has disrupted operations and squeezed finances throughout the healthcare system for a month, interest in legislating may be rising. Senate Intelligence Committee Chair Mark Warner (D-Va.) plans to draft a bill to address healthcare cybersecurity, for example.
CMS has distributed as much as $3 billion in advance Medicare payments so far, Becerra said at a congressional hearing on President Joe Biden's budget proposals Wednesday.
But HHS can only do so much, Becerra told the House Appropriations Committee subcommittee that oversees the department. Republican Reps. Juan Ciscomani (Ariz.), Dr. Andy Harris (Md.) and John Moolenaar (Mich.), who sit on the subcommittee, signed the letter to Becerra.
Moolenaar was among the subcommittee members who pressed Becerra on the speed, scope and transparency of HHS' actions since the Change Healthcare cyberattack occurred Feb. 21.
"We can only forward through advance payments so much money by law, and so we're restricted," Becerra told Moolenaar. "If the Change Healthcare organization doesn't get its systems back up in place quickly, we'll be constrained by statute on how much flexibility we can have."
At a House Ways and Means Committee hearing later on Wednesday, Becerra said nearly 6,000 providers had received advance Medicare reimbursements.
Becerra emphasized to the Ways and Means Committee that HHS is urging the insurance industry to be more generous. "We're insisting that the insurance companies — that have, by the way, received money from the federal government under Medicare and Medicaid — that they also do the same and make it available to those providers," he said.
HHS and the White House have maintained contact with providers and insurers since the Change Healthcare outage commenced, and have held meetings to ask top executives to do more as providers continue to complain that the public and private assistance offered so far is inadequate.
Four health insurance trade groups wrote Becerra on Tuesday defending the industry's responses to the outage.
"Our members took urgent action to maintain continuity in patient care for millions of Americans," AHIP, the Blue Cross Blue Shield Association, the Alliance of Community Health Plans and the Association for Community Affiliated Plans wrote. "Our members report that patients have broad access to essential and routine medical services and prescriptions without disruption and that the overwhelming majority of providers have resumed claim submissions, received timely payments and maintained their operations."
The American Hospital Association sees things differently.
"Providers still need certainty that they will not face billions in denials for technical reasons beyond their control as a result of the Change Healthcare outage," AHA President and CEO Rick Pollack wrote to Ways and Means Committee Chair Jason Smith (R-Mo.) and ranking member Richard Neal (D-Mass.) Tuesday.
Congress should act to expand HHS' authority to distribute money to struggling providers, Pollack wrote. "We also urge Congress to put forward policies that would alleviate administrative requirements imposed by payers, including Medicare Advantage and other commercial payers," such as prior authorizations and claims filing deadlines, he wrote.
Michael McAuliff contributed to this story
