- Change Healthcare experienced a cyberattack that has impacted claims submission and payment.
- There are temporary fixes in place for those who are impacted.
- Change Healthcare processes 15 billion claims each year totaling more than $1.5 trillion.
What happened?
In late February, Change Healthcare, owned by UnitedHealth Group, experienced a cyberattack. In response to this, Change Healthcare prevented many health-care organizations from submitting claims and getting paid. The attack has not affected the systems that provide direct care to patients.
What is the timeline to restore the Change Healthcare systems?
UnitedHealth Group has published the following timeline for key system functionality to be restored:
- Pharmacy services: Electronic prescribing, claim submission, and payment transmission are now fully functional. Patients can access their medicines, including Optum Rx pharmacies, by sending members their medications based on the date needed.
- Payments platform: Electronic payment functionality will be available for connection beginning March 15.
- Medical claims: UnitedHealth Group expects to begin testing and reestablish connectivity to their claims network and software on March 18, restoring service through that week.
What can providers do in the meantime?
UnitedHealth Group is recommending providers use the workarounds they have established, like the new iEDI claim submission system. More information can be found on the United HealthCare website.
On March 1, Optum launched a Temporary Funding Assistance Program, to help bridge the gap in short-term cash flow needs for providers who received payments from payers that were processed by Change Healthcare. For those who receive funding support, there are no fees, interest, or other associated costs with the assistance. For repayment, providers will receive an invoice once standard payment operations resume and will have 30 days to return the funds.
Additionally, the Centers for Medicare & Medicaid Services (CMS) is taking steps to assist physicians in the wake of the Change Healthcare cybersecurity attack. Also, they made available Change Healthcare/Optum Payment Disruption (CHOPD) accelerated payments to Part A providers and advance payments to Part B suppliers experiencing claims disruptions due to the cyberattack.
What is STS doing to help?
STS, the AMA, and the medical community are urging CMS and UnitedHealth Group to recognize the full extent to which physicians and practices are experiencing financial difficulty. Many practices, especially small and rural practices, are operating on thin margins and may have been hit hard by this outage. We are urging federal officials to address this issue further and include financial assistance, such as advanced payments for physicians.
More information on the final rule can be found on the AMA website.