Skip to main content
  • Medicaid Provider Alert: Provider revalidation has begun and those not completing the process risk disenrollment.  Check your account now to learn when your revalidation is due. More information here.
Elizabeth M. Whitehorn, Director

Provider Notice issued 02/27/2024

 

To:
 All Medical Assistance Program Providers
​Date: ​February 27, 2024
​Re: Medical Programs Billing Continues Despite Change Healthcare Nationwide Outage

A vendor for the Department of Healthcare and Family Services (HFS) is continuing to experience a system outage due to the nationwide cyber security breach experienced by Change Healthcare, an Optum affiliate, as noted in the Provider Notice dated February 22, 2024. Because provider billing has been impacted across all State Medicaid Managed Care Plans, we want to strongly encourage all providers to continue to provide timely access to healthcare services during this disruption. In turn, HFS can provide assurance that all claims will be paid once this situation is resolved.

Beginning late last week, the billing function on the clearinghouse platform operated by Change Healthcare, which is used by managed care organizations to process provider claims, was offline due to the system outage. Further, the clearinghouse platform operated by Availity was temporarily unavailable out of an abundance of caution. Availity was unaffected by the cyber security event. It has resumed full functionality and all claims received during that time are being processed. Change Healthcare continues to be unavailable with no time estimate on restoration.

As a reminder, HFS still does not have the ability to edit or review pharmacy claims and processing billing for FFS customers. However, it is our expectation that pharmacies continue to fill prescriptions as described in the Provider Notice linked above.   

HFS’s managed care organization (MCO) partners have each provided mitigation strategies for their respective provider networks and have been communicating with their providers and HFS to ensure that claims are submitted and payments can be made to providers in a timely fashion.

It is important to HFS and our MCO partners that all providers continue to provide timely access to high quality care during this period of the nationwide outage. Eligible claims for services provided in good faith to eligible customers by providers will be paid.

For questions, please contact the HFS Bureau of Managed Care at 217-524-7478 or the customer’s MCO directly.

 

 

Kelly Cunningham, Administrator

Division of Medical Programs