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24-279 The DMHC Encourages Flexibility After Cyberattack on Change Healthcare

Learn how you can assist providers affected by this incident and maintain delivery system stability.

On February 21, 2024, Change Healthcare, a software and data analytics subsidiary of UnitedHealth Group’s Optum unit, and a major claims clearinghouse handling approximately 50% of all medical claims in the United States, experienced a cybersecurity incident that resulted in nationwide product outages impacting payers, providers and pharmacies.

In response to this incident, on March 11, 2024, the Department of Managed Health Care (DMHC) issued All Plan Letter 24-005, Flexibilities to Ensure Delivery System Stability Following Cyberattack of Change Healthcare. APL 24-005 strongly encourages health plans, their Independent Practice Associations (IPA), their delegates, downstream entities and capitated hospitals using Change Healthcare’s services to adopt flexibilities to ensure system stability.

As a California Wellcare provider partner, the DMHC and Wellcare highly encourage you to take the following actions to help ensure system stability for your providers during this outage.

• Waive electronic claim submission requirements and accept paper claims.
• Remove or relax timely claims requirements and not deny received claims as untimely.
• Continue to process and pay claims in a timely manner.
• If prior authorizations were impacted, consider removing and/or relaxing prior authorization requirements.
• Provide regular updates through online platforms such as websites and portals.

Información adicional

For additional information regarding the Change Healthcare incident or how you can help ensure system stability during this outage, refer to the resources provided below or contact the Provider Engagement team by email at HN_Provider_Relations@healthnet.com.