On March 6, the National Association of Chain Drug Stores (NACDS) submitted a letter to the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) urging immediate action to “mitigate healthcare disruptions stemming from the recent cyberattack on Change Healthcare.”
NACDS said, “Pharmacies remain fully committed to promoting uninterrupted access to care for the patients and communities they serve nationwide. NACDS strongly and respectfully requests HHS’ and CMS’ collaboration and partnership in addressing this critical issue to help preserve essential access to healthcare for the American people.”
The NACDS letter specifically calls on HHS and CMS to work collaboratively with pharmacies and other healthcare entities to help mitigate immediate and long-term impacts to patients by taking the following actions:
- Pharmacy Guidance on Delayed Billing of Prescription Claims and Estimated Timeline of Outage: CMS should publish specific and clear guidance for pharmacies on the delayed billing of prescription claims to Medicare and Medicaid plans impacted by the Change Healthcare cyberattack. CMS should also waive any existing penalties, extraneous requirements or deadlines to reasonably support pharmacies’ delayed billing of claims given the current extreme and uncontrollable circumstances.
- Mitigation of Harmful PBM Restrictions and Undue Requirements: HHS and CMS should work closely with pharmacy benefit managers (PBM) impacted by the Change Healthcare disruption to strongly encourage PBMs to act in good faith on claims affected by the current incident as an important means of preserving patient access to care, in addition to mitigating unfair audits.
- Support for Pharmacies and Health Plan Programs Partnering with Alternate Prescription Processors: HHS and CMS should work with Change Healthcare — and other prescription processing companies — to mitigate any friction or unnecessary burden for pharmacies to partner with multiple, or different, prescription processing companies as a means of mitigating the current disruption, in addition to mitigating the prevalence of health plan programs that are exclusive to one prescription processor.
- Exploring Emergency Solutions, Tools and Policy Levers to Mitigate Pharmacy Impacts: HHS and CMS should work with pharmacies and other healthcare providers and states to explore, and ultimately implement, solutions to mitigate both immediate impacts of the current disruption and potential future incidents, such as the Emergency Prescription Assistance Program (EPAP), among others.
- Addressing Potential HIPAA Breaches: HHS should work closely with Change Healthcare to address any potential or actual HIPAA breaches that result from this incident, including all required patient, media and government notifications, as well as the filing of any required breach reports.
