An Ohio urgent care chain could be forced to stop paying rent and other bills to cover payroll. Florida cancer centers are scrambling to raise money for chemotherapy drugs to avoid delays in critical treatment for patients. And in Pennsylvania, family doctors are cutting back on expenses and pooling all their cash, including stashes in personal banks, in hopes of getting by for the next two months.
These are the severe financial implications facing healthcare providers, from large hospital networks to small clinics, in the aftermath of a two-week-old cyberattack that crippled the nation's largest billing and payment system. This is just one example of the strain. The attack took down some electronic systems run by Change Healthcare, a large division of UnitedHealth Group, and disrupted hundreds, if not thousands, of health care providers' ability to prescribe medications. It is no longer possible to obtain insurance approval for services ranging from surgery to mastectomies. or receive payment for those services.
In recent days, the disruptive nature of this chaotic breakdown in daily, often invisible transactions has led top lawmakers, powerful hospital industry executives, and patient groups to pressure the U.S. government for relief. On Tuesday, the Department of Health and Human Services announced it would take steps to ease the financial pressure on some affected people. The primary beneficiaries of the new measures are hospitals and doctors who receive Medicare reimbursement.
U.S. health officials said they will allow health care providers to apply to Medicare for early payments similar to upfront funds made available during the pandemic to tide them over. They also called on health insurance companies to waive or loosen often-criticized rules requiring prior approval that create barriers to accessing medical care. It recommended that insurance companies offering private Medicare plans also provide upfront funding.
HHS has said it is trying to coordinate efforts to avoid disruption, but these early government efforts are a sign that Change Healthcare, which serves as a digital clearinghouse connecting doctors, hospitals and pharmacies, is still offline. It remains unclear whether the gap left by large-scale operations can be filled. To the insurance company. We are handling three of his domestic patient records and one of hers.
The hospital industry criticized the response, saying the measures were insufficient.
In addition to news of another medical cyberattack, the closure of a portion of Change Healthcare also precipitates the consolidation of medical companies, physician groups, and other entities under UnitedHealth Group. It once again attracted attention. United's acquisition of Change in a $13 billion deal in 2022 was initially challenged by federal prosecutors, but the deal was cleared after the government lost the case.
So far, United Airlines has not provided a timeline for reconnecting this critical network. “Patient care is our top priority and we have multiple workarounds in place to ensure people get the medications and care they need,” United said in an update to its website. .
However, on March 1, a Bitcoin address associated with a group of alleged hackers known as AlphV or BlackCat received $22 million in transactions. Some security companies claim the ransom was probably paid by United Airlines to the group. Wired. United Airlines declined to comment, as did the security company that first discovered the payments.
Still, the long-term impact of the attack once again exposed the vast interconnected web of electronic health information and patient data vulnerabilities. Change processes approximately 15 billion transactions annually.
The suspension of some of Change's operations severed its digital role in connecting providers and insurers in submitting claims and receiving payments. This delayed claims payments to medical providers by tens of millions of dollars. Pharmacies were initially unable to dispense medications for many patients because their insurance could not be verified, and healthcare providers accumulated large amounts of unpaid insurance money in the two weeks after the cyberattack occurred.
“This clearly highlights the vulnerabilities in our health care system,” said Ryan S. Higgins, a lawyer at McDermott Will & Emery who advises healthcare providers on cybersecurity. said. The same organization believed to be behind the Change attack was responsible for the 2021 cyberattack on the Colonial Pipeline, a Texas-to-New York pipeline that transports 45 percent of the East Coast's fuel supply. It is being “They have targeted historically important infrastructure,” he said.
Immediately after the Feb. 21 attack, pharmacies initially struggled to fill prescriptions because they were unable to verify individuals' insurance status. In some cases, patients had to pay in cash to receive medicines and vaccinations. However, they have apparently resolved these issues by relying on other companies and/or developing workarounds.
“After almost two weeks, the operational crisis is over and almost over,” said Patrick Berryman, executive vice president of the National Association of Community Pharmacists.
But as the shutdown drags on, doctors, hospitals and other health care providers struggle to pay their bills without steady revenue coming in from private insurance companies, Medicare and Medicaid.
Arlington Urgent Care, a chain of five emergency centers around Columbus, Ohio, has about $650,000 in unpaid insurance claims. Concerned about cash, chain store owners are considering how to pay their bills, including rent and other expenses. Chief Operating Officer Molly Fulton said they took out a bank line of credit and used personal savings to secure enough funds to pay employees for about two months.
“It's worse than when COVID-19 hit, because even though we didn't get paid for a while back then, at least we knew there was a solution,” Fulton said. “There's no end in sight here. We don't know when Change will come back.”
The hospital industry called Change's intrusion “the most significant cyberattack on the U.S. health care system in U.S. history” and called on the federal government and United for emergency funding. The American Hospital Association, an industry group, has been harshly critical of United Airlines' previous efforts and its latest effort to offer a loan program.
“We are far from filling the gaping financial hole,” the trade group's president, Richard J. Pollack, said in a letter to United Airlines President Dirk McMahon on Monday.
“What we need is a real solution, not a program that sounded good when it was announced but is fundamentally inadequate when you read the fine print,” Pollack said.
This financing program is not well-received domestically.
Diana Holmes, a therapist in Attleboro, Massachusetts, received an offer from Optum to loan her $20 a week after failing to file claims for about $4,000 in work she has done since February 21. Ta. she said.
She said there was virtually no communication from Change or the patient's primary insurance company, Blue Cross of Massachusetts. “It's just so frustrating,” she said. She was forced to find a new clearinghouse with her upfront fees and her one-year contract. “We had to pivot quickly without any information,” she said.
Blue Cross said it is working with providers to find various workarounds.
Gainesville's Florida Cancer Specialists and Research Institute is spending $300 million a month on chemotherapy and other drugs for patients who can't delay treatment, leading to new deals with two competing clearinghouses. Appealed.
“We don't have that kind of money sitting in banks,” said Dr. Lucio Gordan, the institute's director. “We don’t know how to recoup or recover the double costs that come with having multiple clearinghouses.”
Dr. Christine Meyer, who runs a primary care practice with 20 clinicians in Exton, Pennsylvania, west of Philadelphia, sent “hundreds of pages” of Medicare bills to the agency in a FedEx box. sent. Dr. Meyer said she is looking at ways to cut costs and save cash, such as reducing the amount of vaccine supplies the clinic has. She said if she could raise all the cash and line of credit, the practice would be able to survive for about two-and-a-half months.
Dr. Meyer said he received a $4,000 loan through Optum's temporary financial assistance program, compared to the approximately $500,000 he would normally submit through Change. “This is less than 1 percent of my monthly bill, and to add insult to injury, this notice has big red letters on it that say, “If the problem is resolved, I will pay the full amount.'' It said I had to return it,” Dr. Meyer said. “It's all a joke.”
The hospital industry is calling on Medicare officials and lawmakers to address the situation by providing free cash to hospitals. Sen. Chuck Schumer, D-N.Y. and House Majority Leader, wrote a letter Friday urging federal health officials to make early payments possible. “The longer this disruption lasts, the harder it will be for hospitals to continue to provide comprehensive medical services to patients,” he said.
Sen. Schumer said in a statement that he welcomed the HHS announcement because it will “infuse funding to health care providers as our health care system continues to be disrupted by this cyberattack.” He added: “We cannot stop this work until all affected health care providers have enough financial stability to weather this storm and continue serving their patients.”
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