Patients in Wisconsin and across the country have been struggling for months to fill prescriptions while pharmacies and clinics have been unable to bill their services to insurance.
A cyberattack on Change Healthcare, a subsidiary of the megacorporation UnitedHealth Group, is to blame.
Many pharmacies including Hayat Pharmacy in Milwaukee have spent weeks doing patient-by-patient assessments to figure out how to get medicine to patients even though they couldn’t bill through insurance.
The hack is squarely the fault of those who perpetrated it. Yet the scope of the problems it has created for providers demonstrates why extreme consolidation of health care is bad for patients. According to Change Healthcare, it processes 15 billion health care transactions a year, which is why a hack of one company was and is catastrophic to patients and providers.
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Following the hack, Change Healthcare was forced to take its processing services offline to protect patient and provider data. This meant that pharmacies and clinics could not run their invoices through insurance. In some cases, a manual workaround was created, or some providers worked with a different processing company.
For those impacted by the loss of processing, it meant providing care for patients without being able to bill for that work. This endangers both patient access and provider livelihood.
Clinics and pharmacies are sitting on stacks of unpaid invoices, which are still accumulating. They face real risk that they won’t be able to continue operating, due to severely reduced income.
Stolen data may include names, Social Security numbers, addresses, phone numbers, email addresses, dates of birth or death, member numbers, Medicare numbers and Medicaid numbers.
But Change Healthcare faces no such concern. In fact, the American Hospital Association wrote a letter to the U.S. Department of Health and Human Services highlighting that Change Healthcare and UnitedHealth are still benefitting financially by accruing interest. Multiple media reports demonstrate that United Healthcare and its executives continue to reap millions in profit while providers struggle to adapt.
The threat presented by cybercriminals is only magnified by corporate consolidation, regardless of the industry. Government oversight is needed to ensure that our private companies are maintaining proper levels of security, given the ever-changing threat by sophisticated cybercriminals.
UnitedHealth Group ranks tenth on the 2023 Fortune Global 500. Later this month, its CEO will testify before the Senate Finance Committee.
Patients and providers here in Wisconsin and across the country need answers about this ongoing crisis. I look forward to this hearing, and how Congress can use what it learns to prevent such debilitating attacks in the future.
Gundermann is the president and CEO of the Coalition of Wisconsin Aging and Health Groups: gundermann@cwag.org.