May 3, 2024: Advocacy Update spotlight on Change Healthcare cyberattack adverse impact

The AMA conducted an informal follow-up survey (PDF) of the Federation of Medicine on the continuing impacts that the Change Healthcare cyberattack has had on physician practices.

Overall, respondents reported continuing issues with multiple operations, despite UnitedHealth Group’s (UHG) announcements of restored service:

• 60% continue to face challenges in verifying patient eligibility
• 75% still face barriers with claim submission
• 79% still cannot receive electronic remittance advice
• 85% continue to experience disruptions in claim payments

It is important to note that service disruptions continue to severely impact practices’ financial well-being, as 90% of respondents are losing revenue from unpaid claims and more than 25% of respondents report that their practice revenue for the last week was down by over 70% compared to an average week before the cyberattack. In addition, 62% of respondents said they are still using personal funds to cover practice expenses and 34% are not able to make payroll. However, despite these challenges, and consistent with previous AMA survey results, only 15% of respondents reported reducing office hours in an effort to prioritize patient care.

Patients are also continuing to face challenges with 42% of respondents stating that patients are unable to access coverage and cost information and 30% responding that patients cannot pay co-pays at the time of service.

In response to questions around possibly switching clearinghouses, some respondents said that they took advantage of that option, but many practices said that they are unable to switch or are choosing not to switch due to substantial barriers. The survey found that 54% of the respondents who did not switch clearinghouses cited the time commitment required as a main barrier, while 32% said a switch was not supported by their EHR or practice management system. In addition, 25% shared that switching to an alternative clearinghouse was too expensive and 36% cited incompatibilities with payers’ systems or restrictions due to contract exclusivity.

The information flow from UHG on when service is going to be restored is also leading to confusion for physicians. The survey indicated that 84% of respondents are not receiving information, or are receiving inaccurate information, regarding service restoration from UHG and its subsidiaries.

Respondents also indicated that health plans are not offering administrative flexibilities in response to the Change Healthcare cyberattack: 30% reported that they are required to complete prior authorizations on claims impacted by the service outage and 27% conveyed how claims have been denied for failing to meet timely filing requirements.

UHG CEO Andrew Witty testified in two separate hearings this week, one in the Senate Finance Committee and another in the House Energy and Commerce Subcommittee on Oversight and Investigations. While Witty stated that “claims flow across the entire country is essentially back to normal,” the AMA’s statement for the record (PDF) to the Senate Finance Committee and letter (PDF) to the House Energy and Commerce Subcommittee on Oversight and Investigations strongly and convincingly argued that physician practices—particularly small practices and/or those operating in rural areas—continue to struggle from the aftershocks of the cyberattack. The AMA included its most recent survey results in its comments to members of Congress to underscore that, despite messaging from UHG, commercial health plans and insurer associations, this crisis is far from being resolved for many physicians. The AMA provided the following recommendations on how Congress, the administration, UHG and other health plans should focus their efforts in support of physicians, practices and patients: 

• Provide financial assistance to impacted physician practices, 
• Immediately suspend prior authorization, quality reporting and other administrative requirements, 
• Prevent denials on claims and appeals impacted by the outage, 
• Improve the transparency and accuracy of information going to physicians, 
• Focus on restoring function for small, independent physician practices, 
• Ensure the HIPAA-related reporting requirements and notification obligations fall upon Change Healthcare and not physicians and other providers, 
• Establish flexibility and leniencies in loan repayments and recoupments, and 
• Ensure the long-term financial stability of physician practices through Medicare payment reform. 

Questioning and statements from members of Congress reflected many of these issues, indicating that the AMA and Federation of Medicine have successfully elevated physicians’ ongoing concerns and need for financial and administrative relief. The AMA will continue to stay engaged with UHG, the Department of Health and Human Services, and other health plans as this challenging situation continues. For more information, please visit the AMA’s website.

• May 3, 2024: Medicare Payment Reform Advocacy Update
• May 3, 2024: National Advocacy Update
• May 3, 2024: State Advocacy Update