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Information for Providers Affected by Change Healthcare Cyberattack

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This notification is for providers affected by the Change Healthcare cyberattack that need to request an override for timely filing of claims that could not be submitted timely due to the cyberattack. The Texas Administrative Code (TAC) allows the Texas Health and Human Services Commission (HHSC) to consider exceptions to the 95-day filing deadline and the 120-day appeal deadline under special circumstances. 1 TAC §354.1003(e)(1)(A) allows for an exception to the 95-day claim filing deadline when a catastrophic event substantially interferes with normal business operations of the provider. 1 TAC §354.1003 allows exceptions to the 120-day appeal deadline.

Required Documentation for Timely Filing Override Requests

Providers must submit the following documentation (*ensure email is encrypted due to client/patient information) to the HHSC Medicaid and CHIP Services Administrative Appeals mailbox at to request an override for timely filing. Any incomplete requests will be rejected.

  1. The provider’s National Provider Identifiers (NPIs).
  2. Documentation that verifies that the provider was using Change Healthcare for claim submissions for the timeframe when the exception is being requested. Examples may include business agreements or a contract.
  3. In accordance with 1 TAC §354.1003 (e)(2), all claims to be considered under the exception.

    a. Include all Texas Medicaid claim Internal Control Numbers (ICNs).

  4. In accordance with 1 TAC §354.1003 (e)(2)(A), an affidavit or statement from the provider that details the cause for the delay, the exception being requested (in this case, providers are requesting the catastrophic event exception), and verification that the delay was not caused by neglect, indifference, or lack of diligence of the provider or the provider’s employee or agent.
  5. Evidence that the provider was unable to submit claims due to the Change Healthcare incident. Examples of evidence may include a written notification from Change Healthcare or a screenshot showing that the system was inaccessible. This evidence will satisfy the requirement of 1 TAC §354.1003 (e)(2)(B).

Temporary Funding Assistance Program for Providers

HHSC is not accepting advanced payment requests. Change Healthcare is providing loans to give some relief during this time. More information can be found on the Temporary Funding Assistance Program web page.

Checking a Claim Status

Providers are encouraged to use one of the several functions on the web portal that can be used to check the status of claims that they may not have received responses for or Remittance and Status (R&S) files for. TexMedConnect offers the functionality to check claim status or to download PDF versions of weekly R&S Reports for most providers that have a web portal account. Providers can also use the EDI X12 276/277 transaction to submit claim status inquiry requests in batches.

Requesting to Change Clearinghouses

Providers have the option to change clearinghouses. To make this change, call the Electronic Data Interchange (EDI) help desk at 800-925-9126 (option 4).

Email if you have any questions on how to submit your request.