Change expects to start testing and restoring service on March 18
The time line means significant financial disruption for physician practices that will extend past 26 days, AMA says.
Photo: HIMSSMedia
UnitedHealth Group said it expects to begin testing and re-establish connectivity to its claims network and software on Monday, March 18, restoring service through that week.
All major pharmacy claims and payment systems are back up and functioning, UHG said.
"While we work to restore these systems, we strongly recommend our provider and payer clients use the applicable workarounds we have established – in particular, using our new iEDI claim submission system in the interest of system redundancy given the current environment," UHG said.
The American Medical Association called this a financial disruption.
AMA President Dr. Jesse M. Ehrenfeld said: "The March 18 time line for testing Change Healthcare claims systems means significant financial disruption on physician practices will extend past 26 days before there is the possibility of establishing reliable network connections. The prospect of a month or more without a restored Change Healthcare claims system emphasizes the critical need for economic assistance to physicians, including advancing funds to financially stressed medical practices."
Rick Pollack, president and CEO of the American Hospital Association, said: "We appreciate the information that UnitedHealth Group has laid out regarding an aspirational time line of potential technical relief for this historic cyberattack on the U.S. healthcare system. However, nothing in the announcement materially changes the chronic cash flow implications and uncertainty that our nation's hospitals and physicians are experiencing as a result.
"Even after Change Healthcare's technology is restored, it will be weeks – if not months – before our hospitals and other healthcare providers will be made whole.
Financial Assistance
More financial assistance is on its way in addition to the Temporary Funding Assistance Program that providers said fell short. The temporary program is to help bridge the gap in short-term cash flow needs for providers who received payments from payers that were processed by Change Healthcare.
UnitedHealthcare said it will provide further funding solutions by advancing funds each week representing the difference between providers' historical payment levels and the payment levels post attack. This applies to medical, dental and vision providers.
Advances would not need to be repaid until claims flows have fully resumed, UHG said.
"We recognize these programs will not work for everyone," UHG said. "Beyond UnitedHealthcare's provider funding relief, Optum is expanding its funding program to include providers who have exhausted all available connection options, and who work with a payer who has opted not to advance funds to providers during the period when Change Healthcare systems remain down. This expansion is a funding mechanism of last resort, especially for small and regional providers, and will be evaluated on a case-by-case basis."
An Optum Pay account is required to complete registration and to receive funds and repay funds.
Ehrenfeld said: "The AMA agrees with UnitedHealth's call for all payers to advance funds to physicians as the most effective way to preserve medical practice viability during the financial disruption, especially for practices that have been unable to establish workarounds to bridge the claims flow gap until the Change Healthcare network is reestablished."
More work needs to be done, he said.
"Full transparency and security assurances will be critical before connections are re-established with the Change Healthcare network," Ehrenfeld said.
Other UHG Updates
- Pharmacy services: Electronic prescribing is now fully functional with claim submission and payment transmission also available.
- Payments platform: Electronic payment functionality will be available for connection beginning March 15.
- Additional Consumer Actions: For Medicare Advantage plans, including Dual Special Needs Plans, Change is temporarily suspending prior authorizations for most outpatient services except for Durable Medical Equipment, cosmetic procedures and Part B step therapies.
- It is also temporarily suspending utilization review for MA inpatient admissions.
- For Medicare Part D pharmacy benefits, Change is temporarily suspending drug formulary exception review processes. These actions will remain in place until March 31.
Email the writer: SMorse@himss.org
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