The cyberattack brought down the country’s largest health-care payment system, producing financial upheaval for a wide range of organizations, from massive hospitals to single-doctors.
Cyberattack: An urgent care franchise in Ohio may be forced to cease paying rent and other payments in order to pay its employees. A cancer facility in Florida is racing to raise funds for chemotherapy medications in order to avoid delaying essential treatments for its patients. In Pennsylvania, a primary care doctor is reducing expenses and pooling all of her resources — even her personal bank account — in the hopes of remaining afloat for another two months.
These are just a few examples of the severe cash crunch that medical care providers — from huge hospital networks to the smallest clinics — are facing in the aftermath of a two-week-old cyberattack that crippled the country’s main billing and payment system. The attack forced the shutdown of parts of Change Healthcare’s electronic system, a sizable unit of UnitedHealth Group, leaving hundreds, if not thousands, of providers unable to obtain insurance approval or be reimbursed for services ranging from a drug prescription to a mastectomy.
Cyberattack: In recent days, the chaotic magnitude of this sprawling breakdown in daily, often unnoticed transactions prompted senior politicians, prominent medical business leaders, and patient groups to press the US government for assistance. The Health and Human Services Department stated on Tuesday that it will take steps to reduce financial constraints on some of those affected. The new measures would mostly assist hospitals and clinicians who get Medicare reimbursements.
U.S. health officials said they would allow clinicians to apply to Medicare for accelerated payments, similar to the enhanced financing provided during the pandemic, to help them get by. They also asked health insurers to waive or reduce the much-criticized norms requiring prior permission, which have become obstacles to accessing care. They also proposed that insurers that offer private Medicare plans provide advanced money.
H.H.S. said it was coordinating efforts to avoid disruptions, but it was unclear whether these early government efforts would fill the gaps left by Change Healthcare’s still-offline mega-operations, which serve as a digital clearinghouse connecting doctors, hospitals, and pharmacies to insurers. It handles up to one out of every three patient records in the country.
Cyberattack : The healthcare business criticized the response, calling the measures inadequate.
Aside from the announcement of the harm inflicted by another health care cyberattack, the suspension of parts of Change Healthcare refocused attention on UnitedHealth Group’s merging of medical enterprises, doctors’ groups, and other organizations. The acquisition of Change by United in a $13 billion deal in 2022 was initially opposed by federal prosecutors but was approved after the government lost its case.
United has not yet released a schedule for reestablishing this vital network. In a website update, United stated, “Patient care is our top priority and we have multiple workarounds to ensure people have access to the medications and the care they need.”
However, a Wired story states that on March 1, a $22 million transaction was received by a bitcoin address linked to the purported hackers, AlphV or BlackCat, which several security professionals believe was likely a ransom payment from United to the gang. Both United and the security company that first discovered the payment chose not to comment.
Nevertheless, the attack’s lingering repercussions have once again highlighted the fragility of patient data and the enormous, interconnected webs of electronic health information. Every year, Change processes about 15 billion transactions.
Change’s digital role of facilitating the submission of invoices and payment between providers and insurers has been disrupted by the closure of part of its operations. Tens of millions of dollars in insurance payments to providers have been postponed as a result. Because they were unable to confirm the patients’ insurance, pharmacies were first unable to fill the prescriptions of numerous patients, and in the two weeks following the incident, providers had racked up substantial amounts of unpaid claims.
Cyberattack: According to Ryan S. Higgins, a cybersecurity advisor with McDermott Will & Emery, “it absolutely highlights the fragility of our health care system.” The Change attack is believed to be the work of the same group that was implicated in the 2021 hack on the Colonial Pipeline, a pipeline that transported 45% of the petroleum supply to the East Coast from Texas to New York. He declared, “They have historically targeted critical infrastructure.”
Pharmacies had the most difficulty filling prescriptions in the early days following the attack on February 21 because they were unable to confirm a patient’s insurance coverage. In several instances, patients had to pay cash in order to receive medication or immunizations. However, it appears that they have worked around these issues or turned to other businesses to get past them.
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https://www.nytimes.com/2024/03/05/health/cyberattack-healthcare-cash.html
“The operational crisis is done and is pretty much over,” stated Patrick Berryman, senior vice president of the National Community Pharmacists Association, after nearly two weeks had passed.
However, as the shutdown drags on, physicians, hospitals, and other providers are finding it increasingly difficult to cover costs since the reliable sources of income from Medicare, Medicaid, and private insurance are just not coming in.
Cyberattack: Sixty-five percent of the insurance reimbursements owed by Arlington Urgent Care, a chain of urgent care facilities located in Columbus, Ohio, are still outstanding. The chain’s owners are worried about money and are considering how they will pay rent and other expenditures. According to chief operating officer Molly Fulton, they have utilized personal savings and bank lines of credit to accumulate enough cash to pay staff for around two months.
“Even though we weren’t paid for a while after Covid hit, at least we knew there would be a fix,” Ms. Fulton claimed, making this worse than that incident. There simply isn’t a finish in sight here. I don’t know when Change will be back up.
The hospital sector has called the Change intrusion “the most significant cyberattack on the U.S. health care system in American history” and has asked United and the federal government to provide immediate financial support. The trade association American Hospital Association has taken a harsh stance against United’s previous attempts as well as its most recent campaign, which included a financing scheme.
The president of the trade association, Richard J. Pollack, wrote a letter to United President Dirk McMahon on Monday stating, “It falls far short of plugging the gaping holes in funding.”
Mr. Pollack stated, “We need real solutions, not programs that sound good on paper but turn out to be fundamentally flawed when you read the fine print.”
The nation has not reacted favorably to the lending program.
Attleboro, Massachusetts therapist Diana Holmes says she hasn’t been able to submit almost $4,000 in claims for her services since February 21. Optum has offered to lend her $20 per week. She remarked, “It’s not like we have reserves.”
Cyberattack: She claims that neither Change nor Blue Cross of Massachusetts, the primary insurer for her patients, have spoken with her in any meaningful way. It’s simply frustrating, she remarked. She must now locate a new payment clearinghouse with a one-year contract and an upfront cost. She remarked, “You’ve had to pivot quickly with no information.”
Blue Cross stated that it was collaborating with providers to identify other solutions.
Gainesville’s Florida Cancer Specialists and Research Institute, which spends $300 million a month on chemotherapy and other medications for patients whose treatments cannot be postponed, has turned to new contracts with two rival clearinghouses.
