UnitedHealth's 'band-aid' payment for Change disruption falls short, hospitals say
UHG's Temporary Funding Assistance Program, as well as contractual terms, are unacceptable, AHA says in letter.
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UnitedHealth Group's Temporary Funding Assistance Program to resume payment operations for hospitals dealing with the aftermath of Change Healthcare's disruptive cyberattack "is not even a band-aid on the payment problems you identify," the AHA wrote in a March 4 letter to UHG president and Chief Operating Officer Dirk McMahon.
The UnitedHealth temporary funding program was unveiled on March 1 following the February 21 cyberattack on Change, which is owned by UHG subsidiary Optum. Blackcat ransomware is behind the attack, the Optum status page confirmed.
Change disconnected its systems after discovering the cyberattack. The resulting disruption to hospitals that use Change's claims services has prevented them from getting paid, according to the American Hospital Association.
"Restoring this flow of payments is critical to support patient care as we continue to see impacts related to prior authorizations for care, pharmacy operations, and claims transmittals and payment," said the letter from AHA President and CEO Richard Pollack. "Regrettably, the Temporary Funding Assistance Program that your company announced on Friday is not even a band-aid on the payment problems you identify."
The AHA said it also took issue with the limited eligibility and one-sided contractual terms, which "severely undermine the intent of this program," Pollack said.
"Indeed, we have heard from some hospitals and health systems that these simply are not terms they can accept, especially when their financial future becomes more unpredictable the longer Change Healthcare is unavailable," the letter said.
No date has been given to the full restoration of services but Change has been initiating workarounds for such services as fulfilling pharmacy prescriptions.
"We have completed standing up a new instance of Change Healthcare's Rx ePrescribing service. (Clinical Exchange ePrescribing providers' tools are still not operational)," according to a March 1 status update. "Working with technology and business partners, we have successfully completed testing with vendors and multiple retail pharmacy partners for the impacted transaction types. As a result, we have enabled this service for all customers effective 1 p.m. CT, Friday, March 1, 2024."
WHY THIS MATTERS
The cyberattack led to Change Healthcare disconnecting its systems, which disrupted operations for hospitals, physician groups, pharmacies and other healthcare organizations that rely on Change's claims services to get paid.
Consumers having issues at the pharmacy counter getting their prescriptions filled have resorted to paying out-of-pocket for their drugs.
"As we await more information from UnitedHealth Group about how long these effects will last – still no timeline has been announced – the financial consequences for hospitals and health systems will only increase, further affecting patient care," AHA said. "We need real solutions – not programs that sound good when they are announced but are fundamentally inadequate when you read the fine print."
The cyberattack shows the vulnerability of interconnected healthcare services.
Change Healthcare processes 15 billion healthcare transactions annually and touches one in every three patient records, according to the AHA. These transactions include a range of services that directly affect patient care, the AHA said, including eligibility verifications and pharmacy operations, as well as claims transmittals and payment.
"All of these have been disrupted to varying degrees over the past several days," the letter said.
The AHA said it extends its full support to UHG as it manages the aftermath of the "unprecedented cyberattack," and that it appreciates UnitedHealth Group has come to recognize "the urgency of resuming payment operations and continuing the flow of payments through the healthcare ecosystem."
THE LARGER TREND
Optum acquired Change in 2022, after winning their court case to merge. The Department of Justice had challenged the deal.
The AHA advised all healthcare organizations that were disrupted or potentially exposed to Change Healthcare's cybersecurity incident to disconnect from Optum.
Email the writer: SMorse@himss.org
