Advocacy Update

April 19, 2024: Advocacy Update spotlight on Change Healthcare cyberattack survey results

. 4 MIN READ

Contents

  1. Informal AMA survey underscores impact of the Change Healthcare cyberattack on physician practices
  2. More articles in this issue
Informal AMA survey underscores ongoing, devastating impact of the Change Healthcare cyberattack on physician practices

Informal AMA survey underscores ongoing, devastating impact of the Change Healthcare cyberattack on physician practices

An informal AMA survey (PDF) on the impacts of the Change Healthcare cyberattack demonstrates threats to the viability of physician practices across the country, as well as serious patient care implications. The survey was conducted from March 26 through April 3 and involved a convenience sample of more than 1,400 respondents.

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The findings include significant disruptions in the ability of practices to submit claims and receive payment on those claims. Despite assurances from UnitedHealth Group (UHG) that a large percentage of claims are being submitted and processed, 36% of those who responded reported suspended claim payments, 32% are still unable to submit claims and 22% are unable to verify eligibility for benefits.

The AMA also heard from physician practices who are unable to obtain electronic remittance advice from health plans, even when they receive payment. In fact, 39% of the AMA survey respondents are having trouble obtaining electronic remittance advice. In addition, 31% of physicians who responded are using manual and electronic workarounds to simply get paid on claims and to be able to submit claims to payers. Moreover, 44% of respondents reported being unable to purchase supplies, 31% were unable to make payroll, and 85% have had to commit additional staff time and resources to complete revenue cycle tasks. However, even against the backdrop of these remarkable challenges, only 15% of practices who responded to the recent survey have reduced office hours.

Following the release of the survey results, the AMA continues to call for immediate action to assist physicians and their practices in maintaining solvency and keeping their doors open for patients. Assistance should come in the form of advance payments, administrative relief, and a targeted focus on restoring practices’ electronic systems, including financial assistance/advance payments from all payers based on claims history.

UHG has put programs in place to assist physicians and other providers. The Temporary Funding Assistance for Providers is designed to help bridge the gap in short-term cash flow needs for physicians and other providers impacted by the disruption of Change Healthcare’s services. In particular, UHG encourages practices that find the amount prepopulated in the Optum Pay system insufficient to meet their financial needs to please contact UHG—either submit a request through the Temporary Funding Assistance Program Form or call 1-877-702-3253.

UHG has informed the AMA that it has no plans or timetable yet to require repayment of these funds. Until all claims submission and payment systems are back up and running, UHG is not requesting repayment. UHG indicated that a practice-level, phased approach will be used to ensure that an individual organization’s functionality has been restored before repayment is requested.

Moreover, additional information about the CMS Change Healthcare/Optum Payment Disruption (CHOPD) program is available online. Physicians and other Medicare providers experiencing disruption because of the Change Healthcare outage can apply for “amounts representative of up to 30 days of Medicare claims payments.” HHS also distributed these resources to assist physicians, pharmacists and hospitals in the aftermath of the Change Healthcare cybersecurity attacks. More information on CHOPD is available from a CMS Fact Sheet. Interested practices should contact their Medicare Administrative Contractor for assistance.

The AMA is also continuing to call for:

  • Suspension of all prior authorization, quality reporting and similar administrative requirements
  • A broader focus on restoring function for independent physician practices
  • A prohibition on retroactive denials based on eligibility or lack of utilization management approval
  • Waivers for timely filing deadlines for claims and appeals

Given the lack of communication on the extent of the breach, the AMA is also asking for more information on the scope and the impact on patients’ data, as physician practices are frequently the first and primary contact for patients to the health care system.

More information and further details on AMA’s informal survey and next steps for government and all stakeholders is available in a statement from the AMA (PDF) in reference to a House of Representatives Committee on Energy and Commerce Subcommittee on Health “Examining Health Sector Cybersecurity in the Wake of the Change Healthcare Attack” hearing on April 16.

The AMA will continue to stay engaged with UHG, CMS and other payers throughout this challenging situation. For more information, please go to the AMA’s website. The AMA expects that many of these issues will be raised at several upcoming hearings occurring in Congress.

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Table of Contents

  1. Informal AMA survey underscores ongoing, devastating impact of the Change Healthcare cyberattack on physician practices
  2. More articles in this issue

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