U.S. Tells Health Insurers to Relax Rules After Hack Cripples Approvals Network

Many health plans, particularly private versions of Medicare and Medicaid, require permission in advance for certain procedures, hospital admissions or medications. The requests, known as prior authorizations, are already considered burdensome by doctors and patients and have become even more challenging with Change’s networks down.

Lifting the rules could speed access to care for patients. It would also add more uncertainty for insurers that have a harder time gauging their expenses because of the hack’s disruption.

Since some systems to submit claims and receive payments are down, hospitals, pharmacies and other providers have alerted regulators to risks of cash-flow interruptions. The agency is offering assistance to help doctors switch their billing systems to other networks that are still online. HHS also said hospitals can seek accelerated Medicare payments from the contractors that manage those transactions.

Credit: UnitedHealth

Copyright 2024 Bloomberg. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.