Change Healthcare Cybersecurity Issue May Impact Claims Submissions

Update March 20, 2024:

Change Healthcare expects the payment platform to begin restoring the medical claims network in mid-March. As of March 13, all major pharmacy and payment systems are functioning and more than 99% of claims volume is currently processing. UnitedHealth began reconnecting the claims system the week of March 18. For more information, visit the Change Healthcare Cyber Response webpage.

Update March 13, 2024:

An interim forensic update including updates on pharmacy functions, the claims network, payment, relief programs, and the restoration of services was posted to the UnitedHealth Group status page.

Update March 12, 2024:

UnitedHealth Group has updated their timeline to restore services:

• Pharmacy services: Electronic prescribing is now fully functional with claim submission and payment transmission also available as of March 11.
• Payments platform: Electronic payment functionality will be available for connection beginning March 15.
• Medical claims: Testing is expected to begin next week to reestablish connectivity to the claims network and software on March 18, restoring service through that week.

Call Spoofing: We are hearing that some providers may have received calls from unknown parties saying they are from a BCBS plan and collecting HEDIS medical records. There was no caller ID and did not identify themselves by name. If you get a potential spoofing call, the please contact the FCC private entity robocall and call spoofing portal. We’re also hearing of an uptick in attempted fraud related to username and password change requests from individuals. Please be aware of these attempts.

Update February 27, 2024:

Change Healthcare, acquired by UnitedHealthcare and Optum in 2022, was the subject of a sophisticated cybersecurity attack that took place early on February 21. It appears that the primary focus in the attack was the internal operation systems of the Change Healthcare network (domain controllers, local identity providers, etc.).

The Medical Network, which includes pharmacy claims processing and real-time transaction processing (claim status, eligibility) was not the target, but due to the design of the Change Healthcare network, this environment was disabled as a precaution. Change Healthcare has indicated that the threat has been contained and they appear to be the only group compromised.

No other United Healthcare group (including Optum) appears to be impacted and there does not appear to be an indicator that Protected Health Information (PHI) has been involved in this attack. No Premera (LifeWise) systems were impacted due to this event. Change Healthcare is working to restore their systems and will notify when the systems are available.

If you are unable to submit claims due to the system outage at Change Healthcare due to this event, there are two options:

• Availity has enabled their Lifeline system to support providers, whether you use Availity or not. You can submit claims via Availity clearinghouse at no cost on their website.
• Smart Data Solutions (SDS) is set up to assist payers and providers who have been impacted by the breach. Providers can also go directly to the SDS provider portal. If are already using SDS, there is no fee for providers to submit claims.

You can also visit the Premera Healthsource blog for updates on this situation.