LSMS Lobbyist, Sherri Buffington (in red) with Tim Ford, MD and guests
Sen. Thomas Pressly, IV, of Shreveport with his father, Thomas Pressly, III, MD.
Maurice Sholas, MD, Rahn Bailey, MD and Guest
LSMS ASKS LDI FOR HELP REGARDING CHANGE HEALTHCARE CYBER ATTACK
On March 21, 2024, the LSMS on behalf of Louisiana physicians, formally requested the Louisiana Department of Insurance (LDI) and Commissioner Temple help minimize the adverse impacts from the recent cyberattack on Change Healthcare. We know many physicians were unable to verify patient eligibility and coverage, confirm patient cost sharing amounts, communicate with payers for authorizations and notices of admissions, transmit pharmacy prescriptions, file claims (including initial and corrected claims), determine coordination of benefits, or receive reimbursements to support operations. We requested LDI issue a 90-day directive that, at a minimum: • Waives or extends timely filing requirements for initial and corrected claims; • Prohibits payers from denying claims for technical reasons, including: lack of authorization; failure to check electronic eligibility; failure to give notice of admission; failure to receive medical records; coordination of benefits; and failure to timely appeal denials;
• Prohibits recoupments for lack of timely filing or the technical reasons outlined above; • Extends timeframes for filing an internal and/or external appeal; and • Strictly enforces the prompt pay law. Additionally, timely filing limits and technical issues should not lead to inappropriate denials or the recoupment of claims due to the cyberattack on Change Healthcare, and all payments due should be promptly paid to help minimize current cash flow issues. On March 26, 2024, in response to our request, Louisiana Department of Insurance Commissioner Temple issued DIRECTIVE 223. It instructs carriers on their continuing network adequacy and prompt pay obligations during vendor-related system outages and lists mitigation activities they can undertake to demonstrate compliance efforts.
Pictured here from L to R are: Berkley Durbin, MedicineLouisiana; Bethany Blackson, LDH; Rahn Bailey, MD; Matthew Wallace, Christus; Maria Bowen, LSMS and Drew Maranto, LDH.
12 LSMS: YEAR IN REVIEW | 2024
LSMS: YEAR IN REVIEW | 2024 13
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