More than two weeks after a cyberattack, cash-strapped doctors, hospitals and medical providers on Friday sharply criticized UnitedHealth Group’s latest estimate that it would take weeks longer to fully restore a digital network through which hundreds of millions of dollars in insurance payments flow daily.
UnitedHealth said it would take at least two more weeks to test and establish a steady flow of payments for bills that have risen since hackers effectively shut down Change Healthcare, the country’s largest billing and payment clearinghouse, on Feb. 21.
But desperate providers, who have borrowed money to cover expenses and employee payroll, expressed skepticism about that estimate and feared it could take months for the backlog of claims and payments to clear.
“We have a nearly three-week gap in cash flow,” said Brad Larsen, psychologist and founder of Portland Mental Health & Wellness in Oregon, adding that the group has only received about 10 percent of its expected insurance payments. He said the practice needed to borrow $300,000 to cover the first of two payrolls for this month. “It is not good.”
In an apparent attempt to appease some vendors who had expressed disappointment with United’s previous resolution of a loan program that provided emergency payments of just $20 a week, the parent company agreed to provide advances. United announced that its insurer, the largest in the United States, would begin advancing payments to hospitals and doctors based on the amounts billed before the cyberattack.
And since Change manages one in three patient records in the U.S.—equivalent to 15 billion transactions per year—the cyberattack affected not only United’s customers, but those of many other insurers as well. This led UnitedHealth executives to recommend offering advance payments as well. “To me, this is the quickest way to get money into the hands of providers,” Dirk McMahon, United’s president and chief operating officer, said in an interview. .
The scale of the cyberattack, which crippled billing and payments from the simplest prescriptions at a pharmacy to the most expensive doctor’s offices, has shocked the industry and the government. Some have expressed concerns that the worst is far from over, fearing that the ransomware attack has compromised patient data.
UnitedHealth Group has declined to comment on whether its policyholders’ information, whether financial or medical, or through insurance coverage at pharmacies, hospitals or clinics, was hacked. The only response was that she continued to work with law enforcement on an investigation into the attack. The FBI and US cybersecurity experts have conducted an investigation.
On March 1, a Bitcoin address associated with the suspected hackers, a group called AlphV or BlackCat, received a $22 million transaction that some security firms said was likely to be a $22 million transaction, according to a news article in Wired a ransom payment from United to the group. United declined to comment, as did Recorded Future, the security firm that initially discovered the payment.
“United did not disclose what information was given to the hackers,” said Ed Tilley, a licensed clinical social worker in Charlotte, N.C. The information he typically submits for billing on the Change network includes a patient’s date of birth and diagnosis. “If my patients’ identifying information has been exposed, I feel an obligation to tell them,” he said.
Since the cyber attack became known, UnitedHealth Group shares have fallen 7.7 percent.
UnitedHealth Group said payments would not be available until around March 15 and that it would begin reviewing and making the connections that would allow hospitals and doctors to submit claims the week of March 18. However, Mr McMahon acknowledged that this time frame could change. “We are in a very volatile environment,” he said.
“We’re trying like crazy to get these systems to market,” McMahon said.
While most pharmacy transaction gaps appear to have been resolved, he suggested that hospitals and physicians should continue to look for workarounds. However, for some providers this has meant switching to Change’s competitors, who are now inundated with new demands and struggling to cope with increased workloads.
“I submitted a few requests to the new system, which took a few hours, and then I asked, ‘Where are they?'” And then this bubble popped up and said, “Nobody can respond to you right now.” said Angela Belleville, a mental health counselor in Salem, Massachusetts. “I tried again yesterday and the system was completely frozen.”
Other major insurers have been largely silent on whether they would provide advances, as Mr. McMahon had suggested, or offer other relief.
“It was crickets,” said Chip Kahn, president of the Federation of American Hospitals, which represents nonprofit hospitals. As money from previously filed claims begins to dry up, “you’re in the danger zone,” he said.
Smaller businesses in particular don’t have to sit on piles of cash to tide them over while they wait for new refunds.
“We’re now past the two-week mark and people are starting to get worried,” said Maggie Williams, co-owner of Flourish Business Solutions, which advises medical practices on billing.
She says she has received calls from doctors concerned that they may not be able to make payroll or may have to stop providing services to patients in the coming weeks. “Often there are no reserves to maintain services or payroll,” she said.
In a statement, the American Hospital Association, a trade group, said: “Nothing in the announcement materially alters the chronic cash flow impacts and uncertainty facing our nation’s hospitals and physicians as a result.” The group also said it has been “weeks “It would take – if not months – for our hospitals and other healthcare providers to recover.”
The powerful hospital lobby was among those calling on federal officials to ease that pressure by speeding up Medicare reimbursements to providers, similar to efforts during the pandemic to bridge hospitals and doctors.
This week, the Department of Health and Human Services announced a series of steps, including an attempt to advance Medicare payments to providers. The department urged private insurers to do the same and urged private Medicare plans to relax or waive much-criticized prior authorization rules that make it harder for providers to get paid for care.
UnitedHealthcare also announced that it would also relax its pre-authorization requirements for its Medicare Advantage policies by the end of March.
Beyond news of the damage caused by the cyberattack, the closure of parts of Change Healthcare drew renewed attention to the consolidation of medical companies, physician groups and other entities under UnitedHealth Group. United’s acquisition of Change in a $13 billion deal in 2022 was initially challenged by federal prosecutors but was pushed through after the government lost its case.
On Friday, providers who instead sought advice or help from a human in Change Healthcare’s customer support were greeted with a recorded message: “Due to unforeseen circumstances, we are unable to answer your call at this time.” Please try again later. Thank you for the call.” And then the call was disconnected.
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2024-03-08 23:58:28
www.nytimes.com
