Change Healthcare Security Incident

Published 07/10/2024

Update: CMS announced that payments under the Accelerated and Advance Payment Program for the Change Healthcare/Optum Payment Disruption (CHOPD) will conclude on July 12, 2024. You can view the CMS Press Release for more information.

The Centers for Medicare & Medicaid Services (CMS) and Palmetto GBA are aware that Change Healthcare recently experienced a cyberattack.

Change Healthcare is a clearinghouse that connects providers with insurance payers and has operations that impact the submission of Medicare claims, including claims submitted to Palmetto GBA and Railroad Medicare. At this time, there is no indication that Medicare systems have been compromised. This is not a CMS or Palmetto GBA incident.

We understand the need to make sure your patients have continued access to care, and the ability to submit Medicare claims. Palmetto GBA takes these matters very seriously and will provide additional updates should they become available.

If your EDI clearinghouse is impacted, we recommend you check directly with them for further instructions.

Affected parties should be aware of the following flexibilities in place:

CMS recognizes that providers may face significant cash flow problems from the unusual circumstances impacting providers' operations, and — during outages arising from this event — providers may submit accelerated or advance payment requests to their respective servicing Medicare Administrative Contractors (MACs) for individual consideration. The U.S. Department of Health and Human Services (HHS) has provided additional information to the MACs about the specific items and information a provider’s accelerated or advance payment request should contain.

Select the appropriate form below to submit an accelerated or advance payment request.

View the CMS Fact_Sheet_Cyberattack_on_Change_Healthcare (PDF) (March 9, 2024) and the CMS Frequently Asked Questions (March 13, 2024) for more information.

  • Providers may change clearinghouses through the EDI enrollment process. Click the links below for information on EDI enrollment. Providers submitting claims electronically can have multiple Trading Partner IDs, but from the Remittance (X12 835) perspective, they can only be linked to one Trading Partner ID.

References

  • Part B providers can use our eServices portal for claim submissions. This is a free option, and many providers are already enrolled with eServices. The Palmetto GBA eServices portal does not offer batch claim submission. Claims must be submitted one at a time.

References

  • Part A and Home Health and Hospice providers can use FISS Direct Data Entry (DDE) for Part A claim entry. This is a free option. Many providers already use FISS DDE. FISS DDE does not offer batch claim submission. Claims must be submitted one at a time.

References

  • Palmetto GBA offers PC-ACE Pro32, a claims-entry software that allows provider and suppliers to enter their claims in the HIPAA-compliant ASC X12 837 v5010 format. PC-ACE Pro32 is available for Part A, Part B, Home Health and Hospice, and Railroad Medicare claim submissions.

PC-ACE Pro32 Software Downloads

Software and Technical Specifications

Palmetto GBA encourages providers to consider the other electronic alternatives available before submitting the request to submit paper claims. If it is determined that paper claim submission is the only option for you to submit claims, you may submit a waiver request on your company letterhead that includes:

  • Your billing/group PTAN and billing/group NPI
  • Contact phone number and name for this exception request
  • Providers should indicate on the letterhead that the waiver request is being made due to the Change Healthcare cybersecurity incident
  • Please allow two business days for the request to be processed before submitting claims
  • Once approved, please ensure that you are following the paper claim submission guidelines to avoid your claims from being rejected
  • Guidelines for completing a paper claim from can be found in the CMS Internet Only Manual (IOM) 100-04, Claims Processing Manual, Chapter 25 (PDF)

Please submit written documentation to support the need to file paper claims. This request must be approved prior to claim submissions. Please use the addresses or fax numbers below to submit your waiver requests.

JJ Part B

Palmetto GBA – JJ MAC Part B
Attn: Part B ASCA Review
P.O. Box 100306
Columbia, SC 29202-3306
For those who’d like to submit a fax, (803) 870–0159

JM Part B

Palmetto GBA – JM MAC Part B
Attn: Part B ASCA Review
P.O. Box 100190
Columbia, SC 29202-3190
For those who'd like to submit a fax, (803) 462–2699

Railroad Medicare

Palmetto GBA Railroad Medicare Part B
Attn: ASCA Dept.
P.O. Box 10066
Augusta, GA 30999
For those who’d like to submit via fax, (803) 382–2415

JJ Part A

Palmetto GBA – Change Healthcare ASCA Waiver Request
P.O. Box 100305
Columbia, SC 29202

JM Part A/HHH

Palmetto GBA – Change Healthcare ASCA Waiver Request
P.O. Box 100238
Columbia, SC 29202

Once approved, please submit paper claims to the following addresses for U.S. Mail.

JJ Part B

Palmetto GBA
P.O. Box 100306
Columbia, SC 29202-3306

JM Part B

Palmetto GBA
Mail Code: AG-600
P.O. Box 100190
Columbia, SC 29202-3190

JJ Part A

Palmetto GBA – Change Healthcare UB04s
Po Box 100305
Columbia, SC 29202

JM Part A/HHH

Palmetto GBA – Change Healthcare UB04s
Po Box 100238
Columbia, SC 29202

Railroad Medicare

Palmetto GBA Railroad Medicare
P.O. Box 10066
Augusta, GA 30999-0001

Part B

Part A and Home Health and Hospice

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