The American Hospital Association slammed UnitedHealth Group's offer of financial assistance for some healthcare providers in the wake of the cyberattack on Change Healthcare and called on Congress for assistance.
AHA President and CEO Richard Pollack said Change Healthcare parent company UnitedHealth Group's temporary loan program misses the mark. In a letter sent Monday to UnitedHealth Group President and Chief Operating Officer Dirk McMahon, Pollack criticized the initiative for what he described as its limited eligibility criteria and unfair contract terms and conditions.
UPDATE: CMS offers relief to providers affected by Change Healthcare outage
“Regrettably, the Temporary Funding Assistance Program that your company announced on Friday is not even a band-aid on the payment problems you identify,” Pollack said on behalf of the association's members.
The cybersecurity incident, which UnitedHealth Group linked to ransomware group BlackCat (also known as ALPHV or Noberus), has disrupted prior authorizations, claims submissions, payment and operations for nearly two weeks. Providers have been forced to find workarounds to get patients their necessary care but have also had to take on their own financial risk.
UnitedHealth Group last week announced the lending program, aimed at addressing short-term cash flow needs for providers affected by Change's payer system outage. It is not for providers that have experienced claim submission disruptions, according to UnitedHealth Group's website. It will not charge additional fees or interest. Once the standard system is up and running, participating providers are required to repay loans, the company said.
Change Healthcare also launched a temporary version of its Rx ePrescribing service Friday for drugstores and hospital and nursing home pharmacies.
Hospitals typically rely on daily reimbursements from health insurance companies that use Change Healthcare as their claims processor, Pollack said in the letter.
"Every day that core Change Healthcare functionality remains down is a day that providers are not receiving the funding they need to pay doctors and nurses, purchase medical supplies, and keep complex facilities open to provide 24/7 patient care," Pollack said.
Pollack said the assistance fails to give enough support for providers struggling to bill payers. He said the AHA is willing to work with UnitedHealth Group on an alternate program.
He also criticized the terms and conditions of the agreeement, which he said requires loan repayments within five days of notice, allows Optum Financial Services to recoup money without advanced notification and requires providers to turn over a slew of claims payment data.
UnitedHealth Group disputed Pollack's characterization of the terms, saying the agreement requires repayment of loans within 10 days of receiving notice, not five days. It did not immediately provide further comment on the letter.
Pollack also sent a letter Monday on behalf of AHA's members to congressional leaders demanding a whole-of-government response and support from the Health and Human Services Department following what he called “the most significant cyberattack on the U.S. healthcare system in American history."
In the letter addressed to Senate Majority Leader Chuck Schumer (D-N.Y.), Senate Minority Leader Mitch McConnell (R-Ky.), House Speaker Mike Johnson (R-La.), and House Minority Leader Hakeem Jeffries (D-N.Y.), Pollack asked Congress to press HHS on encouraging payers to be more flexible with providers given disruptions out of their control. For example, AHA would like HHS to issue guidance to payers to provide interim or advanced payments and not deny claims because of a lack of prior authorization.
The trade group is also requesting Medicare Administrative Contractors expedite approval of hospital requests for advanced Medicare payments.
Schumer sent a letter Friday to Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure with a similar request, urging the agency to make advanced Medicare payments available to hospitals, pharmacies and other providers affected by the outage.
Workarounds aren’t feasible for the long term, Pollack said in both letters. Manual processes such as typing claims into payer portals or sending by fax creates additional administrative burdens for healthcare workers, while switching vendors could also require additional fees and could take months to properly execute, he said.
American Medical Association CEO Dr. James Madara also sent a letter Friday to HHS Secretary Xavier Becerra asking the department to give guidance on how physician practices should proceed while Change Healthcare's system remains down.
The association highlighted member concerns about billing disruptions and burdens associated with temporary workarounds, as well as heightened financial challenges for small, rural and safety-net facilities.
"We urge HHS to utilize any available emergency funds and authorities to provide critical financial resources to physicians, ensuring they can continue to deliver essential healthcare services during these challenging times," Madara said.
HHS did not immediately return a request for comment on the letters.