On February 21, 2024, the massive Change Healthcare network was infiltrated in an unprecedented cyberattack and one month later, Community Health Centers across the U.S. are still trying to recover and resume normal operations. Change Healthcare is owned by UnitedHealth Group (UHG), processes 15 billion health care transactions annually and are involved in supporting one in every three patient records.
The cyberattack has broadly impacted payments to hospitals, physicians, pharmacists, and other health care providers across the country as well as e-prescribing, clinical and administrative data exchange and support services. For health centers, which care for 31.5 patients nationwide as the largest primary care network, the hack is exacting a toll. Health centers report disruptive and costly challenges with unpaid claims, staff spending long hours troubleshooting problems, filling patient prescriptions, and, in some cases, concerns about meeting payroll due to extensive cash crunches.
Lori Hooks, Director of Quality (DQ) with the Texas Association of Community Health Centers, noted in a recent interview with Reuters that if the situation persists through the end of March, it may be tough to pay bills or employees.
“These are clinics that don’t have a lot of days cash on hand and so they’re the most vulnerable for not being able to make their regular monthly bills and payroll,” she said.
There continue to be new developments. As of March 25, Change Healthcare stood up a new, secure version of their Relay clearinghouse, had e-prescribing fully live, and was working with payers to bring customers online for claims processing and payments using multiple approaches. However, some customers and payers are not able to restore needed services because of issues with porting enrollment data, using the legacy clearinghouse, or because the service is not yet operational. These ongoing issues continue to affect operations, clinical care and claims and payments.
What NACHC is Doing
NACHC is working directly with UHG to mitigate impact with a focus on delays in claims processing and payment. UHG has set up multiple Temporary Funding Assistance Programs to help providers with short-term cash flow needs. NACHC can direct health centers to the escalation path if they are not receiving adequate assistance. NACHC staff members are also in direct and regular communications with federal stakeholders– the Centers for Medicare and Medicaid Services (CMS) and the Health Resources and Services Administration (HRSA) and relaying information. NACHC also raised concerns about the impact on health centers in a recent letter to Health and Human Services Secretary Xavier Becerra:
“Patients are being impacted in a multitude of ways,” writes NACHC President and CEO Kyu Rhee, MD, MPP. “Many of our health centers’ pharmacies have reported the inability to process prescription assistance programs (PAPs) and discount cards or complete insurance eligibility checks. As you know, health centers serve patients that are more likely to have chronic conditions and experience adverse social drivers of health. Any disruption to care or patient affordability concerns have negative impacts that can deter patients from getting care in the future.”
While UHG says the situation is stabilizing and is trying to bring payment systems back online, full recovery will take some time. The company also has made more than $2 billion available in emergency funding. NACHC is posting updates on the website and gathering data from health centers to support gaps in the response. NACHC encourages affected health centers to:
- Contact UHG immediately to access the latest information and to sign up to receive Client Assistance at their incident site: https://www.unitedhealthgroup.com/changehealthcarecyberresponse
- Contact your payers to access additional assistance and payment programs
- Contact your EHR vendor to access additional assistance and payment programs
- Reach out to NACHC if the solutions above are not resolving the impact of the incident on your health center at jskapik@nachc.com and vkeys@nachc.com
NACHC’s website is continuously updated with the most latest information on the Change incident including FAQs. NACHC is also preparing a survey to Community Health Centers to gather data on the scope and magnitude of the hack on patients and providers.
Health centers can fill out our incident impact form.
We will continue to update with new developments.