More than two weeks after a cyber attack, doctors, hospitals and health care providers slammed UnitedHealth Group’s latest on Friday assessment that it would take more weeks to fully restore a digital network that channels hundreds of millions of dollars in insurance payments every day.
UnitedHealth said it will take at least two more weeks to test and establish a steady flow of payments for bills that have surged since hackers effectively shut down Change Healthcare, the nation’s largest billing and payment clearinghouse, on Feb. 21.
But desperate providers borrowing money to cover expenses and pay workers have expressed skepticism at that estimate, worried it could be months before the backlog of claims and payments clears up.
“We have almost a three-week gap in cash flow,” said Brad Larsen, a psychologist and founder of Portland Mental Health & Wellness in Oregon, adding that the group had received only about 10 percent of its expected insurance payouts. He said the practice had to borrow $300,000 to cover the first of two payrolls for the month. “It’s not good.”
In an apparent move to mollify some providers who had expressed frustration with United’s earlier treatment of a loan program that offered interim payments of just $20 a week, the parent company agreed to issue advances. United announced that its insurer, the largest in the United States, will begin advancing payments to hospitals and doctors based on amounts billed before the cyber attack.
And since Change manages one in three patient records in the US — amounting to 15 billion transactions a year, the cyber attack affected not only United’s customers but many other insurers as well. That led the UnitedHealth executive to recommend they also offer upfront payments. “To me, this is the fastest way to get money into the hands of the carriers,” Dirk McMahon, United’s chairman and chief executive, said in an interview. .
The depth of the cyberattack, which paralyzed billing and payments, from the simplest prescriptions at a pharmacy to the most expensive surgeries, has shocked industry and government. Some have raised concerns that the worst is not over, fearing that the ransomware attack has compromised patient data.
UnitedHealth Group declined to comment on whether its policyholders’ information — whether financial or medical or through pharmacy, hospital or clinic coverage — had been compromised. Her only response was to say she continues to cooperate with law enforcement agencies on an investigation into the attack. The FBI and US cybersecurity experts conducted an investigation.
On March 1, a Bitcoin address linked to the suspected hackers, a group known as AlphV or BlackCat, received a $22 million transaction that some security firms said was possibly a ransom payment from United to the group, according to a news article in the Wired. United declined to comment, as they did Recorded Futurethe security company that originally traced the payment.
“United has not disclosed what information has been shared with the hackers,” said Ed Tilley, a licensed clinical social worker in Charlotte, N.C. Among the information he typically submits for billing to the Change network is a patient’s date of birth and diagnosis. . “If my patients’ identifying information has been exposed, I feel obligated to tell them,” he said.
Since the cyber attack became public, UnitedHealth Group’s stock has fallen 7.7%.
UnitedHealth Group said payments won’t start becoming available until around March 15, and that it will begin testing and building the connections that will allow hospitals and doctors to submit claims the week of March 18. But Mr McMahon acknowledged that that time frame could change. “We’re in a very fluid environment,” he said.
“We’re continuing like crazy to bring these systems out,” Mr McMahon said.
While most gaps in pharmacy transactions appear to have been resolved, he suggested that hospitals and doctors should continue to find solutions. But for some providers, that has meant moving to Change’s competitors, who are now inundated with new claims and struggling to manage increased workloads.
“I put in a few claims in the new system, which took me a couple of hours, and then I said, ‘Where is it?’ and this bubble popped up saying, “No one can answer you right now.” ” said Angela Belleville, a mental health counselor in Salem, Mass. “I tried again yesterday and the system was completely frozen.”
Other major insurers have been largely silent on whether they will issue advances, as Mr McMahon suggested, or offer other relief.
“They were crickets,” said Chip Kahn, the president of the American Hospital Association, which represents for-profit hospitals. As money from previously filed claims starts to dry up, “you’re in the danger zone,” he said.
Smaller businesses, in particular, aren’t sitting on piles of cash that could topple them while they wait for renewed reimbursements.
“We’re past the two-week mark now and people are starting to worry,” said Maggie Williams, co-owner of Flourish Business Solutions, which advises medical practices on billing.
He says he’s getting calls from doctors who are concerned that they may not be able to make payroll or that they may eventually have to stop providing services to patients in the coming weeks. “A lot of times, there’s no inventory to be able to maintain services or payroll,” he said.
In a statement, the American Hospital Association, a trade group, said: “Nothing in the announcement materially changes the long-term cash flow impact and uncertainty facing our nation’s hospitals and physicians as a result.” The group also said it would be “weeks – if not months – before our hospitals and other health care providers are fully equipped.”
The powerful hospital lobby has been among those urging federal officials to ease those pressures by accelerating Medicare reimbursements to providers, similar to efforts made during the pandemic to tide over hospitals and doctors.
This week, the Department of Health and Human Services announced a series of steps, including an effort to advance Medicare payments to providers. The department urged private insurers to do so as well and called on private Medicare plans to relax or waive much-criticized pre-authorization rules that make it harder to pay providers for care.
UnitedHealthcare also announced it will relax prior approval requirements for its Medicare Advantage policies through the end of March.
In addition to news of the damage caused by the cyberattack, the shutdown of parts of Change Healthcare has put renewed attention on the consolidation of medical companies, physician groups and other entities under UnitedHealth Group. United’s takeover of Change in a $13 billion deal in 2022 was initially challenged by federal prosecutors, but was completed after the government lost its case.
On Friday, providers seeking advice or help from a customer support person at Change Healthcare were instead greeted with a recorded message: “Due to unforeseen circumstances, we are unable to answer your call at this time. Try your call again later. Thanks for calling.” And then the call was disconnected.