Updates on Change cyberattack: UHG’s timeline for system restorations, key updates around claims and payments in next weeks (updated)

As of 8 March-updated 14 March

UnitedHealth Group released a timeline on restoring Change Healthcare systems.

Prescribing is currently back online, with payments not up until next Friday and the claims network starting testing and brought up through the week of 18 March. Highlights below are from the release. Details in 7 March press release.

  • Electronic prescribing is now fully functional with claim submission and payment transmission available as of 7 March. At the end of the release, there is additional information applicable to pharmacy claims and payments, as well as Optum Rx PBM.
    • Update: UHG announced on 13 March that the pharmacy network and payment systems were operational and 99% of pre-incident claim volume is restored. There are some pharmacies remaining offline. Reuters
  • Electronic payment functionality will be available for connection beginning 15 March (next Friday)
  • Testing and reestablishing connectivity to the claims network and software on Monday 18 March restoring service through that week.

Bottom line: the two critical functions of payments and claims will not be fully restored for a month (the cyberattack began on 21 February. Testing of the claims network is not full functionality. Reading between the lines, don’t bet on the week of 18 March for a complete restoration.

Editor’s note: Claims drive payments. There is a massive backlog. Providers could be out of pocket for months or working through reconciliations with UHG, if they participate in temporary funding.

Buried in the release: “we strongly recommend our provider and payer clients use the applicable workarounds we have established—in particular, using our new iEDI claim submission system in the interest of system redundancy given the current environment.”

The rest of the release recaps UHG’s temporary funding proposal, which the American Hospital Association had previously criticized as having ‘shockingly onerous’ terms that were “not even a band-aid on the payment problems” [TTA 5 March]. It has been improved with UHG advancing payments weekly and removing fees and interest. Repayment also seems sensible if the reconciliations are done correctly; “providers will receive an invoice once standard payment operations resume and will have 30 days to return the funds.” Registration is of course required.

UHG is also urging other payers to follow their lead in addressing payments with their providers.

At this point, you can’t expect UHG to disclose why Change Healthcare’s hundreds of systems were so vulnerable–nor whether they paid ransom to BlackCat, as reported. This Editor also wonders how much information on claims and payments, going back before 21 February, was lost. 

Other funding updates:

UHG will suspend until 31 March:

  • Prior authorizations for most outpatient services except for Durable Medical Equipment, cosmetic procedures, and Part B step therapies. This applies to Medicare Advantage (MA), including Dual Special Needs Plans (D-SNP).
  • Drug formulary exception review processes for Medicare Part D pharmacy benefits

UHG will work with state Medicaid agencies on actions they wish to implement.

Becker’s, Healthcare Dive

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